AUTISM DIAGNOSTIC CENTER (NPI# 1265066385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265066385 |
| Entity Type | Organization |
| Organization Name | AUTISM DIAGNOSTIC CENTER |
| Practice Address |
1405 International Mall Las Cruces NM 88003 |
| Mailing Address |
P.o. Box 30001 Msc 3spe Las Cruces NM 88003 |
| Practice Telephone | 5756462235 |
| Practice Fax Number | 5756467712 |
| Mailing Telephone | 5756462235 |
| Mailing Fax Number | 5756467712 |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | DENISE M. SANCHEZ (COLLEGE ASSISTANT PROFESSOR/SLP) |
| Authorized Official Telephone | 5756462235 |
| Authorized Official Credential | M.A., CCC-SLP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
1405 INTERNATIONAL MALL |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275847915 | Aishah Yaasmeen Ortega | Speech-Language Pathologist | 1405 International Mall, Speech Bldg. Room 158, Las Cruces, NM 88003-1279 | 2010-08-05 |
| 1417351545 | Srikanta Mishra | Audiologist | 1405 International Mall, Speech Building Room 158, Las Cruces, NM 88003 | 2014-10-17 |
| 1366758393 | Marlene B Salas-provance | Speech-Language Pathologist | 1405 International Mall, Speech Bldg. Room 158, Las Cruces, NM 88003-1279 | 2010-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245851369 | Amanda Jean Esquibel | Dietitian, Registered | 1780 East University Ave, Las Cruces, NM 88003 | 2020-04-29 |
| 1104455286 | New Mexico State University | Health Educator | 940 College Drive, Las Cruces, NM 88003 | 2020-04-02 |
| 1942847462 | Lucinda Banegas-carreon | Health Educator | 940 College Dr., Corner of Knox and College, Las Cruces, NM 88003 | 2019-12-03 |
| 1154849412 | Yong Woo An | Specialist/Technologist | 1652 Stewart St, Las Cruces, NM 88003 | 2017-09-06 |
| 1093105033 | New Mexico State University | Counselor | 3080 Breland, Ms, Las Cruces, NM 88003 | 2015-01-29 |
| 1225460421 | Marcel Montanez | Counselor | 1220 Stewart Street, O'donnell Hall, Rm 047, Las Cruces, NM 88003 | 2013-07-30 |
| 1417394628 | Eve M Adams | Psychologist | 1220 Stewart St, O'donnell Hall, Rm 205, Las Cruces, NM 88003 | 2013-05-29 |
| 1538276142 | Benjamin G Diven | General Practice | Corner of Stewart and Breland, Student Health Center, Box 30001 Msc 3529, Las Cruces, NM 88003 | 2006-08-23 |
| 1093337586 | Vangaurd Genetics, LLC | Clinical Medical Laboratory | 3655 Research Drive, Msc3arp, Genesis-b, Las Cruces, NM 88003 | 2020-05-07 |
| 1982225017 | Bare Nutrition LLC | Clinic/Center | 1780 E University Ave, Las Cruces, NM 88003 | 2020-04-29 |
| Find all providers in zip 88003 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891064150 | Randolph Philip Rountree | Psychologist | 1505 S Don Roser Dr Ste A, Las Cruces, NM 88011-4596 | 2011-12-15 |
| 1871780726 | Richard Nicastro | Psychologist | 1180 Commerce Dr, Las Cruces, NM 88011-8210 | 2007-09-25 |
| 1992928469 | Charles William Blanchard | Psychologist | 3205 Arrowhead Rd, Las Cruces, NM 88011-4786 | 2007-04-11 |
| 1194870303 | Southern New Mexico Psychological Associates Pa | Psychologist | 1655 Don Roser Dr, Las Cruces, NM 88011 | 2007-01-25 |
| 1316013915 | Isobel P Klein Hernandez | Psychologist | 427 N Reymond, Las Cruces, NM 88005 | 2006-11-27 |
| 1609950104 | Donna Jean Small | Psychologist | 2801 E Missouri Ave, #11, Las Cruces, NM 88011-5061 | 2006-10-24 |
| 1801978887 | Stuart S Kelter | Psychologist | 2145 El Paseo Rd, Las Cruces, NM 88001-6008 | 2006-10-19 |
| 1124113600 | Joe B Alexander | Psychologist | 4384 Sandalwood Dr, Las Cruces, NM 88011 | 2006-10-03 |
| 1477561173 | Howard B. Daniels | Psychologist | 1655 S Don Roser Dr, Las Cruces, NM 88011-4545 | 2006-08-04 |
| 1285661041 | David A Sachs | Psychologist | 3521 Del Rey Blvd, Las Cruces, NM 88012-7708 | 2006-06-27 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88003 |
Please comment or provide details below to improve the information on AUTISM DIAGNOSTIC CENTER.
| 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.