Provider Demographics
NPI:1447653332
Name:ALBUQUERQUE COUNSELING SERVICES
Entity type:Organization
Organization Name:ALBUQUERQUE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:505-369-1513
Mailing Address - Street 1:4325 CARLISLE BLVD NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4810
Mailing Address - Country:US
Mailing Address - Phone:505-369-1513
Mailing Address - Fax:
Practice Address - Street 1:4325 CARLISLE BLVD NE
Practice Address - Street 2:SUITE B
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4810
Practice Address - Country:US
Practice Address - Phone:505-369-1513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0121871251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1922271618Medicaid
NM1134531544OtherSELF PAY