Healthcare Provider Details

I. General information

NPI: 1508343096
Provider Name (Legal Business Name): LINDA HARRINGTON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 RIO GRANDE BLVD NW
ALBUQUERQUE NM
87104-2529
US

IV. Provider business mailing address

12 MANZANO RD
CORRALES NM
87048-8385
US

V. Phone/Fax

Practice location:
  • Phone: 505-830-1871
  • Fax:
Mailing address:
  • Phone: 505-792-0571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCMH0197771
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: