WAYNE FAVREAU (NPI# 1730278854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730278854 |
| Entity Type | Individual |
| Full Name | WAYNE FAVREAU |
| Credential | LPCC |
| Practice Address |
1302 Calle De La Merced Espanola NM 87532-2624 |
| Mailing Address |
2551 Coors Blvd Nw Albuquerque NM 87120-1213 |
| Practice Telephone | 5057470081 |
| Mailing Telephone | 5053383320 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2015-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
0100411 | NM | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
0100411 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | XXXXXXX | 05 |
| Street Address |
1302 CALLE DE LA MERCED |
| City | ESPANOLA |
| State | NM |
| Zip Code | 87532-2624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174914220 | David Aguilar | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2015-02-11 |
| 1639574007 | Daniel Archuleta | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2014-10-28 |
| 1821493248 | Kristen Martinez | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2014-10-28 |
| 1033520408 | Tylar Martinez | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2014-05-19 |
| 1396156337 | Rachel Romero | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2014-05-13 |
| 1972941631 | Bernie Ortiz | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2013-06-04 |
| 1932546827 | Alisa Montano | Social Worker | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2013-05-31 |
| 1578909974 | Clarabelle Trujillo | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2013-05-13 |
| 1023359296 | Christopher Alcala | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2013-03-12 |
| 1881932069 | Danielle Ortiz | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2013-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720690423 | David A. Bustos | Non-emergency Medical Transport (VAN) | 1736 Calle Culebra, Espanola, NM 87532 | 2020-08-24 |
| 1407484942 | Rosita Lorreyna Sanchez | Behavior Technician | 3 Calle Baca, Espanola, NM 87532 | 2020-03-30 |
| 1437615564 | Troy Campbell | Counselor | 19525 Tomas Ln, Espanola, NM 87532 | 2019-02-13 |
| 1174099428 | Marisa Anaya | Registered Nurse | 420 N Coronado Ave, Espanola, NM 87532 | 2018-10-15 |
| 1780169938 | Celina Velasquez | Specialist/Technologist | 8 Camino Velasquez Ln., Espanola, NM 87532 | 2018-10-03 |
| 1356864656 | Jacqueline Andrea Zamora Alvarado | Behavior Technician | 3 Boneyard Rd, Espanola, NM 87532 | 2017-07-19 |
| 1619423902 | Mariah Maureen Martinez | Specialist/Technologist | 1421 Montana Vista St, Espanola, NM 87532 | 2016-08-28 |
| 1851847180 | Shannon Vigil | Perfusionist | 829 Calle Juan Jose Vigil, Espanola, NM 87532 | 2016-08-28 |
| 1144684234 | Tanya P. Reyes | Family Medicine | El Centro Family Health, 2010 Industrial Park Rd., Espanola, NM 87532 | 2016-04-05 |
| 1780058768 | Kale Lee Dennis | Massage Therapist | 2 Old Orchard Ln, Espanola, NM 87532 | 2015-11-13 |
| Find all providers in zip 87532 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073134011 | Superhealth, Inc. | Counselor | 19 Lumbre Del Sol, Espanola, NM 87532-6701 | 2020-04-30 |
| 1265869812 | Karen M Cain | Counselor | 210 Guachpangue Rd, Espanola, NM 87532-3424 | 2013-09-27 |
| 1891928370 | Erena Manning | Counselor | 1200 N Paseo De Onate, Espanola, NM 87532-2687 | 2009-08-31 |
| 1447890710 | Darrins Place Inc | Counselor | 720 E Hacienda St, Espanola, NM 87532-2523 | 2020-01-14 |
| 1538486634 | Lori D Moody | Counselor | 1302 Calle De La Merced, Suite H, Espanola, NM 87532-2624 | 2010-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003517 | Megan Aileen Rafferty | Counselor | 1564 Trujillo Rd. S.w., Albuquerque, NM 87105-2857 | 2020-11-02 |
| 1851901243 | David A Weichbrodt LLC | Counselor | 9412 Las Calabazillas Rd Ne, Albuquerque, NM 87111-2540 | 2020-07-31 |
| 1346868882 | Brianna Brush | Counselor | 1945 Amis Ave, Las Cruces, NM 88005-1649 | 2020-07-10 |
| 1568080042 | Cyd Davis-hubler LLC | Counselor | 9301 Indian School Rd Ne Ste 200f, Albuquerque, NM 87112-2884 | 2020-07-10 |
| 1568089225 | Wild Rose Healing LLC | Counselor | 4012 Comanche Rd Ne, Albuquerque, NM 87110-1081 | 2020-06-29 |
| 1477178762 | Nancy Mcdonald | Counselor | 1876 Camino Lumbre, Santa Fe, NM 87505-5612 | 2020-06-11 |
| 1922621986 | Wethree | Counselor | 36 Aventura Rd, Santa Fe, NM 87508-8744 | 2020-05-26 |
| 1891318101 | Candace Michelle Garcia | Counselor | 6011 Arroyo Dr, Farmington, NM 87402-5366 | 2020-05-20 |
| 1255966644 | Roots Eco-therapy, LLC | Counselor | 8 Moots Ct, Tijeras, NM 87059-7004 | 2020-03-06 |
| 1285267807 | Rickey Martin Apodaca | Counselor | 1 University of New Mexico # 63870, Albuquerque, NM 87131-0001 | 2020-02-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WAYNE FAVREAU.
| 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.