COTTONWOOD CLINICAL SERVICES IN NPI 1790019420

NPI Information

NPI: 1790019420
Provider Name: COTTONWOOD CLINICAL SERVICES, IN
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

CLIA Number: 32D2164812

Address:
205 N AUBURN AVE
FARMINGTON, NM
ZIP 87401
Phone: (505) 564-3733
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COTTONWOOD CLINICAL SERVICES, IN is a mental health counselor in Farmington, NM. COTTONWOOD CLINICAL SERVICES, IN NPI is 1790019420. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

205 N AUBURN AVE
FARMINGTON, NM
ZIP 87401-411
Phone: (505) 564-3733
Fax: (505) 564-3788

The provider's authorized official is Kim D Dutremaine .
The authorized official title is Executive Director and has the following contact phone number (505) 564-3733.

The CLIA number assigned to this NPI record is 32D2164812 - other - outpaitient sub abuse with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 9/29/2009 and was last updated on 9/29/2009.

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
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	0090031	NEW MEXICO	No
2	101YM0800X	Counselor	Mental Health	I-06858	NEW MEXICO	Yes

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

NPI Synchronization or Removal

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