Janice L Kiehne, LICENSED MENTAL HEAL
Individual provider Active NPI Counselor · Reserve, NM
NPI 1982813846 · NPPES record last updated Dec 13, 2011
Key facts
- NPI
- 1982813846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 0072471 (NM)
- Practice address
- #1 Foster Road
Reserve, NM 87830 - Phone
- (575) 533-6649
- Fax
- (575) 534-1150
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 0072471 | NM | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Border Area Mental Health Services, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0072471 | ||
| Counselor | 101Y00000X | 0072471 | NM | Yes |
Addresses
Primary practice location
#1 Foster Road
Reserve, NM 87830
Mailing address
PO Box 1349
Silver City, NM 88062-1349
Phone (575) 388-4497
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18728359 | Medicaid | NM |
Other providers in Reserve, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2011. 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.