David Lee Rossen, LMHC
Individual provider Active NPI Mental Health Counselor · Clovis, NM
NPI 1700543147 · NPPES record last updated Nov 19, 2021
Key facts
- NPI
- 1700543147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- T-CTL0220581 (NM)
- Practice address
- 1600 Sutter PL
Clovis, NM 88101-4611 - Phone
- (575) 769-4490
- Fax
- (575) 769-4430
- NPI assigned
- Nov 19, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240513000866 | NM | Practitioner - Mental Health Counselor | 2567803232 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-CTL0220581 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agape Counseling, LLC | Current |
Accepting new patients | |
| Clovis Municipal Schools | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | T-CTL0220581 | NM | Yes |
Addresses
Primary practice location
1600 Sutter PL
Clovis, NM 88101-4611
Mailing address
PO Box 19000
Clovis, NM 88102-9000
Phone (575) 769-4490
Other providers in Clovis, NM
- Cadance Romero
- Kellyann Romero
- Tudy Ann Romero
- Roosevelt County Special Hospital District
- Samwel Rorya
- John Dominick Rossi
- Roswell Home Medical Inc
- Nicholas J Rowley
- Nicholas John Rowley II
- Andrew Roybal
All providers in Clovis, 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 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.