Provider Demographics
NPI:1497643548
Name:ELMAOUED, EMAD
Entity type:Individual
Prefix:
First Name:EMAD
Middle Name:
Last Name:ELMAOUED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50727
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87181-0727
Mailing Address - Country:US
Mailing Address - Phone:505-903-1880
Mailing Address - Fax:
Practice Address - Street 1:3701 SAN MATEO BLVD NE STE 200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1249
Practice Address - Country:US
Practice Address - Phone:505-903-1880
Practice Address - Fax:505-296-3706
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health