Provider Demographics
NPI:1366010829
Name:MESTER, PATRICIA M (LADAC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:MESTER
Suffix:
Gender:F
Credentials:LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N GRANT ST STE A
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-5134
Mailing Address - Country:US
Mailing Address - Phone:575-388-1447
Mailing Address - Fax:575-388-1447
Practice Address - Street 1:603 HADECO DR
Practice Address - Street 2:
Practice Address - City:LORDSBURG
Practice Address - State:NM
Practice Address - Zip Code:88045-1834
Practice Address - Country:US
Practice Address - Phone:575-542-8447
Practice Address - Fax:575-542-8447
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCBT-2023-0449101YA0400X
NM1132175T00000X
NMCTB-2025-0243101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM62879821Medicaid