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NPI Code Detail

MEDICARE: INNER GUIDANCE, LC

MEDICARE: INNER GUIDANCE, LC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134332158
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNER GUIDANCE, LC
Provider Business Mailing Address
First Line : 1025 HERMOSA DR SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-4312
Country : US
Telephone Number : 505-237-0061
Fax Number :
Provider Business Practice Location Address
First Line : 1025 HERMOSA DR SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-4312
Country : US
Telephone Number : 505-237-0061
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MICHELE COLEMAN
Credential : PHD LMFT
Telephone Number : 505-237-0061
Provider Enumeration Date : 05/07/2007
Last Update Date : 02/07/2017

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Directions to “INNER GUIDANCE, LC ” Practice Location

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