| Golden Willow Counseling Llc | |
|
412 Sipapu St Taos NM 87571-6498 | |
| (575) 770-9513 | |
| Not Available |
| Full Name | Golden Willow Counseling Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 412 Sipapu St, Taos, New Mexico |
| Authorized Official Name and Position | Lawrence A Medina (PRACTICE MANAGER) |
| Authorized Official Contact | 5054702887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Willow Counseling Llc 412 Sipapu St Taos NM 87571-6498 Ph: (505) 690-6686 | Golden Willow Counseling Llc 412 Sipapu St Taos NM 87571-6498 Ph: (575) 770-9513 |
| NPI Number | 1346786902 |
|---|---|
| Provider Enumeration Date | 01/06/2017 |
| Last Update Date | 04/03/2020 |
| Certification Date | 04/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346786902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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