Nicole Camille Archuleta
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Espanola, NM
NPI 1720580681 · NPPES record last updated Mar 6, 2018
Key facts
- NPI
- 1720580681
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 0178081 (NM)
- Practice address
- 1227 N Railroad Ave Ste C
Espanola, NM 87532-3159 - Phone
- (505) 747-8187
- NPI assigned
- Mar 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| 0178081 | NM | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Mexico Treatment Services LLC | Past |
Accepting new patients | |
| New Mexico Treatment Services LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0178081 | NM | Yes |
Addresses
Primary practice location
1227 N Railroad Ave Ste C
Espanola, NM 87532-3159
Mailing address
1227 N Railroad Ave Ste C
Espanola, NM 87532-3159
Phone (505) 747-8187
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265683049 | Medicaid | NM |
Other providers in Espanola, NM
- Mark Andrew Angel
- Kristal Anguiano
- Beverly Archuleta
- Christina Archuleta
- Daniel Archuleta
- Rebecca Ann Archuleta
- Jesus Arellano
- Veronica Arenas
- Jamie Arguello
- Diana M Armijo
All providers in Espanola, NM · Addiction (Substance Use Disorder) 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 Mar 6, 2018. 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.