Southeastern Behavioral Associates, Llc | |
518 E 18th St # B Portales NM 88130-9268 | |
(575) 714-3410 | |
Not Available |
Full Name | Southeastern Behavioral Associates, Llc |
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Speciality | Counselor - Professional |
Location | 518 E 18th St # B, Portales, New Mexico |
Authorized Official Name and Position | Sheila Ann Stephenson (CO-OWNER) |
Authorized Official Contact | 5757143410 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southeastern Behavioral Associates, Llc 518 E 18th St # B Portales NM 88130-9268 Ph: (575) 714-3410 | Southeastern Behavioral Associates, Llc 518 E 18th St # B Portales NM 88130-9268 Ph: (575) 714-3410 |
NPI Number | 1447640164 |
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Provider Enumeration Date | 02/02/2015 |
Last Update Date | 02/02/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447640164 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | I-07223 (New Mexico) | Primary |
101YP2500X | Counselor - Professional | 0129911 (New Mexico) | Secondary |
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