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BEHAVIOR AND FAMILY THERAPY SERVICES NPI 1205005196


NPI Information

NPI: 1205005196
Provider Name: BEHAVIOR AND FAMILY THERAPY SERVICES
Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

Address:
1990 E LOHMAN AVE STE 225
LAS CRUCES, NM
ZIP 88001
Phone: (575) 650-8415
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BEHAVIOR AND FAMILY THERAPY SERVICES is a prescribing (medical) psychologist in Las Cruces, NM. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. BEHAVIOR AND FAMILY THERAPY SERVICES NPI is 1205005196. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1990 E LOHMAN AVE STE 225
LAS CRUCES, NM
ZIP 88001-172
Phone: (575) 650-8415
Fax: (575) 521-9215

The provider's authorized official is Robert C. Mayfield .
The authorized official title is Ceo and has the following contact phone number (575) 650-8415.

The enumeration date for this NPI number is 2/25/2008 and was last updated on 6/18/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YP2500XCounselorProfessional0101061NEW MEXICONo
2103TC1900XPsychologistCounselingNM0943NEW MEXICONo
31041C0700XSocial WorkerClinicalI-3644NEW MEXICONo
41041C0700XSocial WorkerClinicalM-05824NEW MEXICONo
51041C0700XSocial WorkerClinicalI-06500NEW MEXICONo
6103TP0016XPsychologistPrescribing (Medical)0010CNEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1NMB2154MEDICARE PIN
210075381MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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