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NPI Code Detail

MEDICARE: BARBARA L CHURCH LPCC

MEDICARE: BARBARA L CHURCH LPCC
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
1101YP2500XProfessional Counselor0096261NM
2101YM0800XMental Health CounselorCCMH0096261

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 : 1942433636
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA L CHURCH LPCC
Provider Business Mailing Address
First Line : 5601 DOMINGO RD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-1610
Country : US
Telephone Number : 505-268-5295
Fax Number : 505-268-9967
Provider Business Practice Location Address
First Line : 5601 DOMINGO RD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-1610
Country : US
Telephone Number : 505-268-5295
Fax Number : 505-268-9967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2009
Last Update Date : 09/24/2020

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Directions to “ BARBARA L CHURCH LPCC” Practice Location

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