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Contact Information

KITCHEN TABLE COUNSELING PROFESSIONAL LLC
333 E JEFFERSON ST
GALLUP, NM87301-5113
 Phone: 360-433-7755
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Case Management

251B00000X
 

Community/Behavioral Health

251S00000X
 

Multi-Specialty

261QM1300X 70 Clinic or Group Practice
Indicates primary specialty

NPI Profile & details for KITCHEN TABLE COUNSELING PROFESSIONAL LLC · (Female)

NPI # 1861098857
Status Active
Credentials
Entity Individual
Enumeration date 12/07/2020
Last updated 12/07/2020 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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