Provider Demographics
NPI:1124137807
Name:ZORUMSKI, CARYLE HOPKINS
Entity type:Individual
Prefix:DR
First Name:CARYLE
Middle Name:HOPKINS
Last Name:ZORUMSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112B ALEXANDER ST
Mailing Address - Street 2:SUITE B2
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6278
Mailing Address - Country:US
Mailing Address - Phone:505-751-0449
Mailing Address - Fax:505-751-0449
Practice Address - Street 1:112B ALEXANDER ST
Practice Address - Street 2:SUITE B2
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6278
Practice Address - Country:US
Practice Address - Phone:505-751-0449
Practice Address - Fax:505-751-0449
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0067192101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0067192OtherLICPROFCLINICAMHCNSELOR