Blackgoat, Elouise

Blackgoat, Elouise is an individual health care provider with primary practice located at 300 W Nizhoni Blvd Ste A , Gallup NM 87301. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Blackgoat, Elouise can be contacted via phone (505) 722-9470.

Contact Information

Primary practice address
300 W Nizhoni Blvd Ste A Gallup NM 87301
Phone: (505) 722-9470
Fax: (505) 722-9570
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0122361 New Mexico
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11440 Arizona
Behavioral Health & Social Service Providers / Counselor 101Y00000X 0122361 New Mexico

Profile Details

NPI number 1043415854
LBN Legal business name Blackgoat, Elouise
Credentials COUNSELOR
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2007
Last updated Jun 28th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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