Take Action LLC

Organization Active NPI Mental Health Counselor · Moriarty, NM

NPI 1558808634 · NPPES record last updated May 10, 2017

Key facts

NPI
1558808634
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
License
0118471 (NM)
Legal business name
TAKE ACTION LLC
Practice address
704 Central Avenue West Suite B
Moriarty, NM 87035
Phone
(505) 901-9143
NPI assigned
Jan 26, 2017
Organization subpart
No

Authorized official

Name
Melissa A Nandino, MA LPCC
Title
Therapist
Phone
(505) 832-9135

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X 0118471 NM Yes

Addresses

Primary practice location

704 Central Avenue West Suite B
Moriarty, NM 87035

Mailing address

PO Box 85
704 US RT 66 Suite B
Moriarty, NM 87035-0085
Phone (505) 832-9135

Other identifiers

IdentifierTypeStateIssuer
51305887MedicaidNM

Other providers in Moriarty, NM

All providers in Moriarty, NM · Mental Health Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.