Provider Demographics
NPI:1477300432
Name:MIDDLE WAY COUNSELING
Entity type:Organization
Organization Name:MIDDLE WAY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:518-428-6881
Mailing Address - Street 1:7558 KACHINA LOOP
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-4042
Mailing Address - Country:US
Mailing Address - Phone:518-428-6881
Mailing Address - Fax:
Practice Address - Street 1:7558 KACHINA LOOP
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-4042
Practice Address - Country:US
Practice Address - Phone:518-428-6881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty