Healthcare Provider Details

I. General information

NPI: 1013557594
Provider Name (Legal Business Name): ONWARD CLEARING COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 HOLLY AVE NE STE T
ALBUQUERQUE NM
87122-2968
US

IV. Provider business mailing address

9400 HOLLY AVE NE STE T
ALBUQUERQUE NM
87122-2968
US

V. Phone/Fax

Practice location:
  • Phone: 505-585-0611
  • Fax:
Mailing address:
  • Phone: 505-585-0611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: WHITNEE NICLEY
Title or Position: OWNER
Credential:
Phone: 505-585-0611