SOUTHEASTERN BEHAVIORAL ASSOCIATES LLC NPI 1447640164

NPI Information

  • NPI: 1447640164
  • Provider Name: SOUTHEASTERN BEHAVIORAL ASSOCIATES, LLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 518 E 18TH ST # B
    PORTALES, NM
    ZIP 88130
  • Phone: (575) 714-3410

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NPI Details

SOUTHEASTERN BEHAVIORAL ASSOCIATES, LLC is a professional counselor in Portales, NM. SOUTHEASTERN BEHAVIORAL ASSOCIATES, LLC NPI is 1447640164. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

518 E 18TH ST # B
PORTALES, NM
ZIP 88130-268
Phone: (575) 714-3410

The provider's authorized official is Sheila Ann Stephenson .
The authorized official title is Co-owner and has the following contact phone number (575) 714-3410.

The enumeration date for this NPI number is 2/2/2015 and was last updated on 2/2/2015.

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
1101YP2500XCounselorProfessional0129911NEW MEXICONo
2101YP2500XCounselorProfessionalI-07223NEW MEXICOYes

What is NPI?

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This page was last updated on: 11/21/2025

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