Project Fernando, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

4878 Issued in NM

Legal business name

PROJECT FERNANDO, LLC

Practice address

1100 S Main St Ste 6
Las Cruces, NM 88005-2917

Phone

(575) 496-6515

Fax

(575) 208-7253

NPI assigned

Oct 12, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lee King

Title

Ceo

Phone

(575) 496-6515

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1487164810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S MAIN ST STE 6",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052917",
            "telephone_number": "575-496-6515",
            "fax_number": "575-208-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S MAIN ST STE 6",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052917",
            "telephone_number": "575-496-6515",
            "fax_number": "575-208-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT FERNANDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "575-496-6515"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "4878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David G. Pritchard, MD
• Lea Marie Pritchet, CPSW
• Stephanie R Privette, RN
• Jerry G Prochazka, LMHC, CRC
• Progressive Residential Services of New Mexico, Inc.
• David Protextor
• Devonna Protextor
• Maria Protextor
• Amanda Bustamante Provencio, MD
• Jeanne Provencio, LPCC

• Addiction (Substance Use Disorder) Counselor in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.