Healthcare Provider Details

I. General information

NPI: 1437643178
Provider Name (Legal Business Name): CLAIRE ELAINE ZEPPONI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2018
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 RESEARCH RD SE
ALBUQUERQUE NM
87123-3423
US

IV. Provider business mailing address

10401 RESEARCH RD SE
ALBUQUERQUE NM
87123-3423
US

V. Phone/Fax

Practice location:
  • Phone: 505-823-4530
  • Fax: 505-823-4530
Mailing address:
  • Phone: 505-823-4530
  • Fax: 505-823-4530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2023-0559
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: