Healthcare Provider Details

I. General information

NPI: 1255885059
Provider Name (Legal Business Name): KATHERINE A ROE SAINZ LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 CARLISLE BLVD NE STE 107
ALBUQUERQUE NM
87110-1663
US

IV. Provider business mailing address

2934 TRUMAN ST NE
ALBUQUERQUE NM
87110-3034
US

V. Phone/Fax

Practice location:
  • Phone: 512-573-5279
  • Fax:
Mailing address:
  • Phone: 512-573-5279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0180941
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number0180941
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: