LEROY JIM LPCC CRC NPI 1063627354

NPI Information

  • NPI: 1063627354
  • Provider Name: LEROY JIM, LPCC, CRC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 2025 E AZTEC AVE
    GALLUP, NM
    ZIP 87301
  • Phone: (505) 863-3828

Map and Directions

Get Directions

NPI Details

Leroy Jim, LPCC, CRC is a professional counselor in Gallup, NM. Leroy Jim, LPCC, CRC NPI is 1063627354. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2025 E AZTEC AVE
GALLUP, NM
ZIP 87301-803
Phone: (505) 863-3828

The enumeration date for this NPI number is 5/11/2007 and was last updated on 6/15/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225C00000XRehabilitation Counselor00056257No
2101YP2500XCounselorProfessional0146941NEW 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
176986063MEDICAIDNEW MEXICO
243929842MEDICAIDNEW 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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI