| Life Quest Counseling, Llc | |
|
116 N Wall Ave Farmington NM 87401-6916 | |
| (505) 297-6616 | |
| (505) 787-2411 |
| Full Name | Life Quest Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 116 N Wall Ave, Farmington, New Mexico |
| Authorized Official Name and Position | Craig Spencer Hutton (OWNER) |
| Authorized Official Contact | 5052976616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Quest Counseling, Llc Po Box 5522 Farmington NM 87499-5522 Ph: (505) 297-6166 | Life Quest Counseling, Llc 116 N Wall Ave Farmington NM 87401-6916 Ph: (505) 297-6616 |
| NPI Number | 1417546367 |
|---|---|
| Provider Enumeration Date | 01/14/2021 |
| Last Update Date | 04/27/2021 |
| Certification Date | 04/27/2021 |
| Medicare PECOS PAC ID | 2062827298 |
|---|---|
| Medicare Enrollment ID | O20210219001149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417546367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Craig Spencer Hutton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427658145 PECOS PAC ID: 3971918103 Enrollment ID: I20210219001263 |
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