Alisha O'Donovan

Individual provider Active NPI Counselor · Rogers, NM

NPI 1871144634 · NPPES record last updated Sep 24, 2019

Key facts

NPI
1871144634
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
License
CMH0196111 (NM)
Practice address
1390 S Roosevelt Road 30
Rogers, NM 88132-9724
Phone
(575) 602-2721
NPI assigned
Sep 24, 2019
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
CMH0196111NMMDCounselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CMH0196111 NM Yes

Addresses

Primary practice location

1390 S Roosevelt Road 30
Rogers, NM 88132-9724

Mailing address

1390 S Roosevelt Road 30
Rogers, NM 88132-9724

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://www.betterhelp.com/alisha-o-donovan/ Direct

Sources for this page

Verify at the official NPI Registry.