Healthcare Provider Details

I. General information

NPI: 1396831095
Provider Name (Legal Business Name): JANET GAYLE MECCA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 BRYN MAWR DR SE SUITE A
ALBUQUERQUE NM
87106-2265
US

IV. Provider business mailing address

PO BOX 93846
ALBUQUERQUE NM
87199-3846
US

V. Phone/Fax

Practice location:
  • Phone: 505-238-1992
  • Fax: 505-797-7941
Mailing address:
  • Phone: 505-238-1992
  • Fax: 505-797-7941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00094791
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number00094791
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: