Healthcare Provider Details

I. General information

NPI: 1083013676
Provider Name (Legal Business Name): NATTY PLUNKETT LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MEDICAL ARTS AVE NE BLDGE 3-100
ALBUQUERQUE NM
87102-2706
US

IV. Provider business mailing address

1101 MEDICAL ARTS AVE NE BLDGE 3-100
ALBUQUERQUE NM
87102-2706
US

V. Phone/Fax

Practice location:
  • Phone: 505-842-5300
  • Fax: 505-998-1362
Mailing address:
  • Phone: 505-842-5300
  • Fax: 505-998-1362

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:
Title or Position:
Credential:
Phone: