Provider Demographics
NPI:1912976648
Name:PSYCHOLOGY & COUNSELING SERVICES INC
Entity type:Organization
Organization Name:PSYCHOLOGY & COUNSELING SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:O
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-865-7100
Mailing Address - Street 1:PO BOX 1757
Mailing Address - Street 2:119 TELES SW
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-1757
Mailing Address - Country:US
Mailing Address - Phone:505-865-7100
Mailing Address - Fax:505-865-7100
Practice Address - Street 1:119 TELLES ST SW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-8518
Practice Address - Country:US
Practice Address - Phone:505-865-7100
Practice Address - Fax:505-865-7100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM174103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN6200Medicaid
NMNM100185OtherVALUEOPTIONS, NM