Provider Demographics
NPI:1063784338
Name:GOLUMB, DAVID J (LMHC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:GOLUMB
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:530 DEMOSS ST
Mailing Address - Street 2:
Mailing Address - City:LORDSBURG
Mailing Address - State:NM
Mailing Address - Zip Code:88045-2618
Mailing Address - Country:US
Mailing Address - Phone:575-542-8384
Mailing Address - Fax:575-542-2388
Practice Address - Street 1:1720 E 32ND ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-8304
Practice Address - Country:US
Practice Address - Phone:575-388-4412
Practice Address - Fax:575-313-2388
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM0141451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM26650355Medicaid
NM26650355Medicaid