Healthcare Provider Details

I. General information

NPI: 1356676605
Provider Name (Legal Business Name): ROBERT CLAY SZENASI LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11825 MARQUETTE AVE NE
ALBUQUERQUE NM
87123-1304
US

IV. Provider business mailing address

11825 MARQUETTE AVE NE
ALBUQUERQUE NM
87123-1304
US

V. Phone/Fax

Practice location:
  • Phone: 505-205-2033
  • Fax: 505-247-9503
Mailing address:
  • Phone: 505-205-2033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCCMH0164891
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: