Provider Demographics
NPI:1447554548
Name:CHAVARRIA, AMY RENEE (LPCC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RENEE
Last Name:CHAVARRIA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 HOOT OWL CT
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88242-0969
Mailing Address - Country:US
Mailing Address - Phone:575-631-8591
Mailing Address - Fax:
Practice Address - Street 1:110 E MESCALERO RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-6542
Practice Address - Country:US
Practice Address - Phone:575-755-2272
Practice Address - Fax:575-622-3325
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0186841101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional