Basic Information
Provider Information
NPI: 1174782148
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAJORS
FirstName: REBECCA
MiddleName: IRENE
NamePrefix: MS.
NameSuffix:  
Credential: LPCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6621 DONIPHAN DR STE G
Address2:  
City: CANUTILLO
State: TX
PostalCode: 798355005
CountryCode: US
TelephoneNumber: 9158775100
FaxNumber: 9158775107
Practice Location
Address1: 6621 DONIPHAN DR STE G
Address2:  
City: CANUTILLO
State: TX
PostalCode: 798355005
CountryCode: US
TelephoneNumber: 9158775100
FaxNumber: 9158775107
Other Information
ProviderEnumerationDate: 06/05/2008
LastUpdateDate: 03/20/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X0135761NMY Behavioral Health & Social Service ProvidersCounselorProfessional

ID Information
IDTypeStateIssuerDescription
VNM30451NI05NM MEDICAID


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