Basic Information
Provider Information
NPI: 1932571544
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CALHOUN
FirstName: ALAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 385 CALLE DE ALEGRA
Address2: BLDG. A
City: LAS CRUCES
State: NM
PostalCode: 880053423
CountryCode: US
TelephoneNumber: 5755261105
FaxNumber: 5755244266
Practice Location
Address1: 100 W GRIGGS AVE
Address2:  
City: LAS CRUCES
State: NM
PostalCode: 880011234
CountryCode: US
TelephoneNumber: 5756472800
FaxNumber: 5756472898
Other Information
ProviderEnumerationDate: 10/21/2015
LastUpdateDate: 04/05/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X0176451NMN Behavioral Health & Social Service ProvidersCounselor 
101YM0800X0176451NMY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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