Robert H Fernando, LADAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Tohatchi, NM
NPI 1891906517 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1891906517
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 3524 (NM)
- Practice address
- Manulito Street Building T006-013
Behavioral Health Services
Tohatchi, NM 87325 - Phone
- (505) 733-2825
- Fax
- (505) 733-2829
- NPI assigned
- May 24, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 3524 | NM | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3524 | NM | Yes |
Addresses
Primary practice location
Manulito Street Building T006-013
Behavioral Health Services
Tohatchi, NM 87325
Mailing address
PO Box 609
Tohatchi, NM 87325-0609
Phone (505) 733-2825
Other providers in Tohatchi, NM
- Kristine Cruz
- Dezbaa Altaalkii Damon-Mallette
- DHHS, PHS, Naihs, Gallup Indian Medical Center
- Carrie Edsitty
- John Jerome Fagel
- Anna George
- Camilo Gonzalez Jr.
- Rolanda Hardy
- Georgia Ann Henry
- Lillian M Jones
All providers in Tohatchi, 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 Jul 8, 2007. 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.