Douglas, Eleanore S

Douglas, Eleanore S is an sole proprietor health care provider with primary practice located at 1011 Flora Dr , Santa Fe NM 87505-5221. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Douglas, Eleanore S can be contacted via phone (505) 310-5988.

Contact Information

Primary practice address
1011 Flora Dr Santa Fe NM 87505-5221
Phone: (505) 310-5988
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 0091581 New Mexico
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0091581 New Mexico
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0091581 New Mexico
Behavioral Health & Social Service Providers / Professional 101YP2500X 0091581 New Mexico

Profile Details

NPI number 1649376989
LBN Legal business name Douglas, Eleanore S
Credentials LPCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2006
Last updated Jul 9th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1649376989 NPPES
New Jersey MEDICAID 58032304

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