| Ravenwater Counseling Llc | |
|
1360 Acapulco Rd Ne Rio Rancho NM 87144-6449 | |
| (970) 371-8683 | |
| Not Available |
| Full Name | Ravenwater Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1360 Acapulco Rd Ne, Rio Rancho, New Mexico |
| Authorized Official Name and Position | Shawn Michael Crawford (OWNER / SOLE MEMBER) |
| Authorized Official Contact | 9703718683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ravenwater Counseling Llc 1360 Acapulco Rd Ne Rio Rancho NM 87144-6449 Ph: (970) 371-8683 | Ravenwater Counseling Llc 1360 Acapulco Rd Ne Rio Rancho NM 87144-6449 Ph: (970) 371-8683 |
| NPI Number | 1821763129 |
|---|---|
| Provider Enumeration Date | 08/10/2021 |
| Last Update Date | 08/10/2021 |
| Certification Date | 08/10/2021 |
| Medicare PECOS PAC ID | 0648616425 |
|---|---|
| Medicare Enrollment ID | O20240314004277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821763129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Shawn Crawford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629066865 PECOS PAC ID: 2163677204 Enrollment ID: I20240314004292 |
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