Theresa Tolth, LSAA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Crownpoint, NM
NPI 1982813127 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1982813127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 79291 (NM)
- Practice address
- Southwest Highland Drive
Crownpoint, NM 87313-1144 - Phone
- (505) 786-2423
- Fax
- (505) 786-5442
- NPI assigned
- May 22, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 79291 | NM | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 79291 | NM | Yes |
Addresses
Primary practice location
Southwest Highland Drive
Crownpoint, NM 87313-1144
Mailing address
Southwest Highland Drive
Crownpoint, NM 87313-1144
Phone (505) 786-2423
Other providers in Crownpoint, NM
- Ragheb Senan
- Mavis Smith
- Sophie Soo
- Roger William Studd
- Thoreau Health Station
- Karen Mai Linh Tong
- Bobbie Lynn Tracy
- Tran Ngoc Tran
- US DHHS Crownpoint Healthcare Facility
- Bobilyn Jo Waite
All providers in Crownpoint, 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.