Lightmoon, Diana

Lightmoon, Diana is an individual health care provider with primary practice located at 5 Caliente Rd Ste 2C , Santa Fe NM 87508-9205. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Lightmoon, Diana can be contacted via phone (505) 577-4607.

Contact Information

Primary practice address
5 Caliente Rd Ste 2C Santa Fe NM 87508-9205
Phone: (505) 577-4607
Fax: (505) 466-1277
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0228 New Mexico

Profile Details

NPI number 1518131689
LBN Legal business name Lightmoon, Diana
Credentials MA, LPCC, LMT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2008
Last updated Jun 30th, 2015 - about 10 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 1518131689 NPPES
New Mexico MEDICAID 67985041

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