Basic Information
Provider Information
NPI: 1003143827
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIELDS
FirstName: AUNDRE
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: BMS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 28220
Address2:  
City: SANTA FE
State: NM
PostalCode: 875928220
CountryCode: US
TelephoneNumber: 5054715006
FaxNumber: 5058209220
Practice Location
Address1: 906 TENTH STREET SUITE C
Address2:  
City: ALAMOGORDO
State: NM
PostalCode: 88310
CountryCode: US
TelephoneNumber: 5754378964
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/16/2009
LastUpdateDate: 11/16/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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