Benjamin Fields, LSAA

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · El Prado, NM

NPI 1366068025 · NPPES record last updated Jun 18, 2020

Key facts

NPI
1366068025
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CSA0211591 (NM)
Practice address
1208 Paseo del Pueblo Norte
El Prado, NM 87529-8752
Phone
(850) 501-0562
NPI assigned
Jun 18, 2020
Sex
Male
Sole proprietor
No

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
CSA0211591NMMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CSA0211591 NM Yes

Addresses

Primary practice location

1208 Paseo del Pueblo Norte
El Prado, NM 87529-8752

Mailing address

PO Box 3229
Taos, NM 87571-3229
Phone (850) 501-0562

Other providers in El Prado, NM

All providers in El Prado, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.