Nicolas Flores, LADAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Canutillo, TX
NPI 1104024199 · NPPES record last updated Jul 11, 2007
Key facts
- NPI
- 1104024199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 3620 (NM)
- Practice address
- 6621 Doniphan Dr Ste G
Canutillo, TX 79835-5005 - Phone
- (915) 877-5100
- Fax
- (915) 877-5107
- NPI assigned
- Jul 11, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3620 | NM | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunwest Behavioral Associates PA | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3620 | NM | Yes |
Addresses
Primary practice location
6621 Doniphan Dr Ste G
Canutillo, TX 79835-5005
Mailing address
6621 Doniphan Dr Ste G
Canutillo, TX 79835-5005
Phone (915) 877-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VNM30451NI | Medicaid | NM |
Other providers in Canutillo, TX
- Maria Concepcion Edmunds
- El Paso City County Health and Environmental District
- Elp Community Healthcare Services LLC
- Roberta Lynn Farley-Icard
- Daniel Owen Fitzpatrick
- Maria Leonila Fonseca- Pineda
- Roberto Gomez
- Vivian Herrera Jr.
- Nicholas B Hogue
- Elizabeth Jaramillo
All providers in Canutillo, TX · Addiction (Substance Use Disorder) Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.