Provider Demographics
NPI:1124843396
Name:MORALES, ASIA LYNNAE (LMHC)
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:LYNNAE
Last Name:MORALES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 N FRAN PL
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-7451
Mailing Address - Country:US
Mailing Address - Phone:575-519-8447
Mailing Address - Fax:
Practice Address - Street 1:415 W HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-3622
Practice Address - Country:US
Practice Address - Phone:575-694-5478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2024-0726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health