Basic Information
| Provider Information | |||||||||
| NPI: | 1548890007 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARAGON | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MA, LSAA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7908 LOCKWOOD CT NW | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871204081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5055144059 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 912 1ST ST NW | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871022355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052249777 | ||||||||
| FaxNumber: | 5052249779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2020 | ||||||||
| LastUpdateDate: | 01/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CSA0207271 | NM | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.