Darryl Benally
Individual provider Active NPI Mental Health Counselor · Gallup, NM
NPI 1366064446 · NPPES record last updated May 12, 2020
Key facts
- NPI
- 1366064446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC-18820 (AZ)
- Practice address
- 1040 Patton Dr
Gallup, NM 87301-7425 - Phone
- (505) 330-9591
- NPI assigned
- May 12, 2020
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-18820 | AZ | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-18820 | AZ | Yes |
Addresses
Primary practice location
1040 Patton Dr
Gallup, NM 87301-7425
Mailing address
1040 Patton Dr
Gallup, NM 87301-7425
Other providers in Gallup, NM
- Kendra Dawn Beller
- Elaine Ben
- Lydia Ben
- Marvena Ben
- Mariah J Benallie
- Dorena Benally
- Nicole Beck Benally
- Raelynn Benally
- Tina Louise Benjamin
- Aisha Bennett
All providers in Gallup, NM · Mental Health Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2020. 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.