Croom, Connie
Croom, Connie is an individual health care provider with primary practice located at 1337 H Gusdorf Rd , Taos NM 87571. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Croom, Connie can be contacted via phone (505) 770-4316.Contact Information
Primary practice address
1337 H Gusdorf Rd
Taos NM 87571
Phone: (505) 770-4316
Fax: (505) 758-3346
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 0085831 | New Mexico |
Profile Details
| NPI number | 1245311851 |
|---|---|
| LBN Legal business name | Croom, Connie |
| Credentials | LPCC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245311851 | NPPES |
| New Mexico | Other | 00JM35 | BC/BS |
| New Mexico | MEDICAID | 202640 | BC/BS |
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