Kathryn Dianne Stephens, LPCC

Individual provider Active NPI Professional Counselor · Deming, NM

NPI 1013100668 · NPPES record last updated Oct 8, 2011

Key facts

NPI
1013100668
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
0105311 (NM)
Practice address
340 Solana Rd SE
Deming, NM 88030-7564
Phone
(575) 546-0708
NPI assigned
Aug 27, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0105311NMMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0105311 NM Yes

Addresses

Primary practice location

340 Solana Rd SE
Deming, NM 88030-7564

Mailing address

340 Solana Rd SE
Deming, NM 88030-7564
Phone (575) 546-0708

Other providers in Deming, NM

All providers in Deming, NM · Professional Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.