Mavis Smith
Individual provider Active NPI Mental Health Counselor · Crownpoint, NM
NPI 1649044710 · NPPES record last updated Nov 9, 2023
Key facts
- NPI
- 1649044710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CCMH02077711 (NM)
- Practice address
- RT 9 Hwy 371 Suite 2
Crownpoint, NM 87313 - Phone
- (505) 786-2333
- NPI assigned
- Nov 9, 2023
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| CCMH02077711 | NM | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CCMH02077711 | NM | Yes |
Addresses
Primary practice location
RT 9 Hwy 371 Suite 2
Crownpoint, NM 87313
Mailing address
P.O. Box 1501
Gallup, NM 87305
Phone (505) 870-1347
Other providers in Crownpoint, NM
- Red Rocks Dialysis LLC
- Roy Salcido
- Carla J Sand
- Cody Schneider
- Ragheb Senan
- Sophie Soo
- Roger William Studd
- Thoreau Health Station
- Theresa Tolth
- Karen Mai Linh Tong
All providers in Crownpoint, NM · Mental Health Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.