| Vicki Matthews Dba | |
|
405 N Date St Ste 9 Truth Or Consequences NM 87901-2378 | |
| (805) 305-1966 | |
| Not Available |
| Full Name | Vicki Matthews Dba |
|---|---|
| Speciality | Counselor |
| Location | 405 N Date St Ste 9, Truth Or Consequences, New Mexico |
| Authorized Official Name and Position | Vicki Marie Matthews (BUSINESS OWNER/ LICENSED COUNSELOR) |
| Authorized Official Contact | 5755201919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vicki Matthews Dba Po Box 1354 Elephant Butte NM 87935-1354 Ph: (805) 305-1966 | Vicki Matthews Dba 405 N Date St Ste 9 Truth Or Consequences NM 87901-2378 Ph: (805) 305-1966 |
| NPI Number | 1215797766 |
|---|---|
| Provider Enumeration Date | 03/21/2024 |
| Last Update Date | 10/10/2024 |
| Certification Date | 10/10/2024 |
| Medicare PECOS PAC ID | 5890136485 |
|---|---|
| Medicare Enrollment ID | O20240514002233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215797766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Vicki Marie Matthews |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548619679 PECOS PAC ID: 9335580927 Enrollment ID: I20240514002315 |
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