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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

NPI # 1861098857
LBN Legal business name KITCHEN TABLE COUNSELING PROFESSIONAL LLC
Authorized official SANDRA GEARY - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/07/2020
Last updated 12/07/2020 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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