Healthcare Provider Details

I. General information

NPI: 1639838998
Provider Name (Legal Business Name): HOT MESS AND A BAG OF CHIPS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 BARSTOW ST NE APT 5104
ALBUQUERQUE NM
87122-2854
US

IV. Provider business mailing address

8100 BARSTOW ST NE APT 5104
ALBUQUERQUE NM
87122-2854
US

V. Phone/Fax

Practice location:
  • Phone: 505-577-8253
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TRACY FABRE
Title or Position: OWNER
Credential: LCSW
Phone: 505-577-8253