Healthcare Provider Details

I. General information

NPI: 1356865091
Provider Name (Legal Business Name): ELIZABETH ANN HOOVER LPC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 HILTON AVE NE
ALBUQUERQUE NM
87110-1174
US

IV. Provider business mailing address

4920 HILTON AVE NE
ALBUQUERQUE NM
87110-1174
US

V. Phone/Fax

Practice location:
  • Phone: 971-716-9878
  • Fax:
Mailing address:
  • Phone: 971-716-9878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2024-0787
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number86806
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: