Provider Demographics
NPI:1558100958
Name:MOUNTAIN PRESENCE COUNSELING
Entity type:Organization
Organization Name:MOUNTAIN PRESENCE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-819-3449
Mailing Address - Street 1:1949 OSAGE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-3330
Mailing Address - Country:US
Mailing Address - Phone:505-819-3449
Mailing Address - Fax:
Practice Address - Street 1:1600 LENA ST.
Practice Address - Street 2:BUILDING C, SUITE 23
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-819-3449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty