Healthcare Provider Details

I. General information

NPI: 1366786980
Provider Name (Legal Business Name): LINDA KAY MOUER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2012
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 VENTURA ST NE
ALBUQUERQUE NM
87122-3970
US

IV. Provider business mailing address

7916 RANCHO DE PALOMAS NE
ALBUQUERQUE NM
87109-6037
US

V. Phone/Fax

Practice location:
  • Phone: 505-856-6578
  • Fax: 505-856-7486
Mailing address:
  • Phone: 505-450-3061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0108991
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: