Provider Demographics
NPI:1528633237
Name:BYRD, SANDY ROSE (LMHC)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:ROSE
Last Name:BYRD
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:PO BOX 881
Mailing Address - Street 2:
Mailing Address - City:TUCUMCARI
Mailing Address - State:NM
Mailing Address - Zip Code:88401-0881
Mailing Address - Country:US
Mailing Address - Phone:575-461-6200
Mailing Address - Fax:
Practice Address - Street 1:102 E HIGH ST
Practice Address - Street 2:
Practice Address - City:TUCUMCARI
Practice Address - State:NM
Practice Address - Zip Code:88401-2726
Practice Address - Country:US
Practice Address - Phone:575-461-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health