Healthcare Provider Details

I. General information

NPI: 1043391261
Provider Name (Legal Business Name): MAE LYNN SPAHR LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 ADAMS ST SE
ALBUQUERQUE NM
87108-2837
US

IV. Provider business mailing address

324 ADAMS ST SE
ALBUQUERQUE NM
87108-2837
US

V. Phone/Fax

Practice location:
  • Phone: 505-235-7399
  • Fax:
Mailing address:
  • Phone: 505-235-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCCMH0175941
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: