Healthcare Provider Details

I. General information

NPI: 1114159753
Provider Name (Legal Business Name): ADOREE ANNE SHUAIB LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2009
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 CANDELARIA RD NE
ALBUQUERQUE NM
87107-1966
US

IV. Provider business mailing address

824 MOUNT TAYLOR AVE
GRANTS NM
87020-2959
US

V. Phone/Fax

Practice location:
  • Phone: 505-514-9361
  • Fax:
Mailing address:
  • Phone: 505-610-5897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCMH0177171
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: