Provider Demographics
NPI:1679288252
Name:GARVER, PAUL DANIEL (LMHC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DANIEL
Last Name:GARVER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6032 REDONDO SIERRA VIS NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-0606
Mailing Address - Country:US
Mailing Address - Phone:703-945-0504
Mailing Address - Fax:
Practice Address - Street 1:5001 INDIAN SCHOOL RD NE STE 200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4082
Practice Address - Country:US
Practice Address - Phone:575-446-3997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2023-0695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty