Basic Information
| Provider Information | |||||||||
| NPI: | 1609252857 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SLEUTH | ||||||||
| FirstName: | NASHEEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 W HICKORY ST | ||||||||
| Address2: | |||||||||
| City: | DEMING | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880304046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755462174 | ||||||||
| FaxNumber: | 5755444821 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 W HICKORY ST | ||||||||
| Address2: | |||||||||
| City: | DEMING | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880304046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755462174 | ||||||||
| FaxNumber: | 5755444821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2015 | ||||||||
| LastUpdateDate: | 01/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 0175651 | NM | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | CCMH0184631 | NM | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.