John Stan Espinoza, LADAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Taos, NM

NPI 1861686511 · NPPES record last updated Sep 5, 2007

Key facts

NPI
1861686511
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
0073521 (NM)
Practice address
413 Sipapu Road
Taos, NM 87571
Phone
(505) 758-5857
NPI assigned
Sep 5, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
0073521NMMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Community Services, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0073521 NM Yes

Addresses

Primary practice location

413 Sipapu Road
Taos, NM 87571

Mailing address

PO Box 1214
Taos, NM 87571-1214
Phone (505) 737-5533

Other providers in Taos, NM

All providers in Taos, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.