Kitchen Table Counseling Professional LLC

NPI #1861098857 in Gallup, New Mexico

Provider Information

NPI Number: 1861098857
Entity Type: Organization
Organization Name: Kitchen Table Counseling Professional LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Dec 7, 2020
Last Updated: Dec 7, 2020

Practice Location

Address: 333 E JEFFERSON ST
City: Gallup
State: New Mexico
ZIP Code: 87301-5113
Phone: (360) 433-7755

Authorized Official

Name: SANDRA GEARY, LCSW
Title: MEMBER
Phone: (360) 433-7755

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X
Community/Behavioral Health	251S00000X
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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