Healthcare Provider Details

I. General information

NPI: 1659159473
Provider Name (Legal Business Name): BARBARA BECK-AZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 CARDENAS DR NE
ALBUQUERQUE NM
87108-1720
US

IV. Provider business mailing address

10700 ACADEMY RD NE APT 716
ALBUQUERQUE NM
87111-7331
US

V. Phone/Fax

Practice location:
  • Phone: 505-266-8168
  • Fax: 505-510-7686
Mailing address:
  • Phone: 505-450-9567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: