Healthcare Provider Details
I. General information
NPI: 1356493647
Provider Name (Legal Business Name): JUDITH FLEISCHMAN & WILLIAM CHAMBREAU, PRTNRS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2007
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1803 LOUISIANA BLVD NE SUITE E-2
ALBUQUERQUE NM
87110-6900
US
IV. Provider business mailing address
1803 LOUISIANA BLVD NE SUITE E-2
ALBUQUERQUE NM
87110-6900
US
V. Phone/Fax
- Phone: 505-266-5959
- Fax: 505-286-1027
- Phone: 505-266-5959
- Fax: 505-286-1027
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
CHAMBREAU
Title or Position: GENERAL PARTNER AND PROVIDER
Credential: LMSW AND LPCC
Phone: 505-247-8853