JEANNE PROVENCIO (NPI# 1629061783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629061783 |
| Entity Type | Individual |
| Full Name | JEANNE PROVENCIO |
| Credential | LPCC |
| Practice Address |
505 S Main St Ste. 129 Las Cruces NM 88001-1206 |
| Practice Telephone | 5055255644 |
| Practice Fax Number | 5056472010 |
| Mailing Telephone | 5055255644 |
| Mailing Fax Number | 5056472010 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
0529 | NM | Behavioral Health & Social Service Providers |
| Street Address |
505 S MAIN ST STE. 129 |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88001-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528692324 | Tahnee Poppy | Psychologist | 505 S Main St, Las Cruces, NM 88001-1206 | 2020-03-02 |
| 1437662699 | Victoria Faith Aguirre | Speech-Language Pathologist | 505 S Main St, Las Cruces, NM 88001-1206 | 2017-11-09 |
| 1245771278 | Kathleen Douglas | Registered Nurse | 505 S Main St, Ste. 249, Las Cruces, NM 88001-1206 | 2017-03-09 |
| 1568900694 | Diana Yandell | Registered Nurse | 505 S Main St, Suite 249, Las Cruces, NM 88001-1206 | 2017-02-09 |
| 1952849325 | Sonya C Martinez | Registered Nurse | 505 S Main St, Ste. 249, Las Cruces, NM 88001-1206 | 2017-02-06 |
| 1902348790 | Blanca E Martinez-rolle | Psychologist | 505 S Main St, Ste. 249, Las Cruces, NM 88001-1206 | 2016-11-09 |
| 1861940074 | Dorie Amber Dwyer | Registered Nurse | 505 S Main St, Suite 249, Las Cruces, NM 88001-1206 | 2016-09-15 |
| 1760937080 | Karen Alcantar | Psychologist | 505 S Main St, Ste 249, Las Cruces, NM 88001-1206 | 2016-08-16 |
| 1841647773 | Justa Ordorica | Registered Nurse | 505 S Main St, Suite 249, Las Cruces, NM 88001-1206 | 2016-05-20 |
| 1013364314 | Riba Calloway | Registered Nurse | 505 S Main St, Ste 249, Las Cruces, NM 88001-1206 | 2016-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020044 | Three Crosses Regional Hospital LLC | General Acute Care Hospital | 2560 Samaritan Drive, Las Cruces, NM 88001 | 2019-12-17 |
| 1760961908 | Halcyon Health of The Southwest, LLC | Nurse Practitioner | 1355 California Ave Ste B, Las Cruces, NM 88001 | 2018-08-08 |
| 1255818530 | Lago Claro, LLC | Counselor | 2410 S. Espina St, Las Cruces, NM 88001 | 2018-07-19 |
| 1407371818 | Elijah Daniel Perez | Behavior Technician | 1535 Myrtle Ave, Las Cruces, NM 88001 | 2017-08-07 |
| 1982128641 | Krystal Marie Ruiz | Psychologist | 505 S. Main, Ste. 249, Las Cruces, NM 88001 | 2017-08-03 |
| 1457886913 | Mathew Petersen Dds PC | Dentist | 2001 E. Lohman Ave. Suite 121, Las Cruces, NM 88001 | 2017-04-21 |
| 1801343439 | Celia Holmes | Registered Nurse | 505 S Main, Ste 249, Las Cruces, NM 88001 | 2016-09-01 |
| 1427420223 | Sara Guidetti | Family Medicine | 3080 Breland Drive, Las Cruces, NM 88001 | 2015-10-20 |
| 1679987234 | Maria De Jesus Martinez | Nurse Practitioner | 1170 N. Solano Ste A, Las Cruces, NM 88001 | 2014-06-11 |
| 1851701494 | Viola E Garcia | Case Manager/Care Coordinator | 100 W Griggs, Las Cruces, NM 88001 | 2014-05-05 |
| Find all providers in zip 88001 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790314227 | Barbara Kay Reese | Counselor | 3553 Roma Dr, Las Cruces, NM 88012-7577 | 2020-04-06 |
| 1285268474 | Elizabeth Calhoun Harvey | Counselor | 115 Los Nogales Dr, Las Cruces, NM 88001-7408 | 2020-02-26 |
| 1104478858 | Angel's Network Counseling Services | Counselor | 811 E Amador Ave, Las Cruces, NM 88001-3378 | 2019-07-12 |
| 1366904526 | Felix Chavez Jr. | Counselor | 2434 Westwind Rd, Las Cruces, NM 88007-5588 | 2019-04-04 |
| 1972083640 | Lorianna R. Narvaez | Counselor | 1155 S. Telshor Suite 302-a, Las Cruces, NM 88011 | 2018-08-21 |
| 1760976468 | Maria Gonzalez | Counselor | 715 E Idaho Ave Ste 2b-e, Las Cruces, NM 88001-4703 | 2018-06-18 |
| 1558850834 | Connections Therapy, Inc. | Counselor | 225 E Idaho Ave Ste 25, Las Cruces, NM 88005 | 2018-05-02 |
| 1912403221 | Kathleen Basler Lmft LLC | Counselor | 716 El Prado Ave, Las Cruces, NM 88005-2968 | 2018-04-04 |
| 1992224117 | Kathleen Nancy Hodges | Counselor | 1772 Buchanan Ave, Las Cruces, NM 88001-8485 | 2017-09-19 |
| 1326565557 | Higgins Therapy Services, Inc. | Counselor | 1990 E Lohman Ave Ste 211, Las Cruces, NM 88001-3172 | 2017-08-28 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88001 |
Please comment or provide details below to improve the information on JEANNE PROVENCIO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.