Rebecca Jane Knowles, LPCC

Individual provider Active NPI Mental Health Counselor · Chaparral, NM

NPI 1629277181 · NPPES record last updated Jul 15, 2007

Key facts

NPI
1629277181
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
0080801 (NM)
Practice address
204 Autumn Sage LN
Chaparral, NM 88081-7732
Phone
(505) 350-5937
Fax
(505) 824-4388
NPI assigned
Jul 15, 2007
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
0080801NMMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0080801 NM Yes

Addresses

Primary practice location

204 Autumn Sage LN
Chaparral, NM 88081-7732

Mailing address

204 Autumn Sage LN
Chaparral, NM 88081-7732
Phone (505) 350-5937

Other identifiers

IdentifierTypeStateIssuer
NM101318MedicaidNM

Other providers in Chaparral, NM

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

Sources for this page

Verify at the official NPI Registry.