Diana Whay

Individual provider Active NPI Mental Health Counselor · Stanley, NM

NPI 1578920302 · NPPES record last updated Jan 25, 2016

Key facts

NPI
1578920302
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
T0178141 (NM)
Practice address
7 Stallion Rd
Stanley, NM 87056
Phone
(505) 948-4942
NPI assigned
Jan 25, 2016
Sex
Female
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

LicenseStateTypeSpecialty
T0178141NMMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X T0178141 NM Yes

Addresses

Primary practice location

7 Stallion Rd
Stanley, NM 87056

Mailing address

PO Box 873
Edgewood, NM 87015-0873
Phone (505) 948-4942

Other providers in Stanley, NM

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

Sources for this page

Verify at the official NPI Registry.