MEDICARE: MS. GINEVRA CLARE SUTHERLAND SANCHEZ LMHC

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
1	101YM0800X	Mental Health Counselor	0130111	NM
2	101YS0200X	School Counselor	273771	NM

General Provider Information

NPI Number	:	1316230501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GINEVRA CLARE SUTHERLAND SANCHEZ LMHC

Provider Business Mailing Address
First Line	:	7108 LEONA ST NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4829
Country	:	US
Telephone Number	:	505-554-9003
Fax Number	:

Provider Business Practice Location Address
First Line	:	7108 LEONA ST NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4829
Country	:	US
Telephone Number	:	505-554-9003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2011
Last Update Date	:	11/10/2025

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