1639876014 NPI number — MS. KATHRYN GINA CAVAZOS CASE MANAGER/CARE CO

Table of content: MS. KATHERINE MARGARET VARRONE PNP (NPI 1710453527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639876014 NPI number — MS. KATHRYN GINA CAVAZOS CASE MANAGER/CARE CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAVAZOS
Provider First Name:
KATHRYN
Provider Middle Name:
GINA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CASE MANAGER/CARE CO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HILL
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
GINA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639876014
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THE COUNSELING CENTER
Provider Second Line Business Mailing Address:
1900 10TH STREET
Provider Business Mailing Address City Name:
ALAMOGORDO
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-488-2500
Provider Business Mailing Address Fax Number:
575-488-2502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE COUNSELING CENTER
Provider Second Line Business Practice Location Address:
1900 10TH STREET
Provider Business Practice Location Address City Name:
ALAMOGORDO
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-488-2500
Provider Business Practice Location Address Fax Number:
575-488-2502
Provider Enumeration Date:
02/15/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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