Healthcare Provider Details

I. General information

NPI: 1104765700
Provider Name (Legal Business Name): WHOLE SELF COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 MONTGOMERY BLVD NE BLDG E15
ALBUQUERQUE NM
87109-1586
US

IV. Provider business mailing address

7501 MONTGOMERY BLVD NE APT 8101
ALBUQUERQUE NM
87109-1582
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-6380
  • Fax:
Mailing address:
  • Phone:
  • 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: LUIS ALVARADO
Title or Position: THERAPIST
Credential: LMSW
Phone: 505-226-2375