Healthcare Provider Details

I. General information

NPI: 1679288252
Provider Name (Legal Business Name): PAUL DANIEL GARVER LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 12/31/2023
Certification Date: 12/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 INDIAN SCHOOL RD NE STE 200
ALBUQUERQUE NM
87110-4082
US

IV. Provider business mailing address

6032 REDONDO SIERRA VIS NE
RIO RANCHO NM
87144-0606
US

V. Phone/Fax

Practice location:
  • Phone: 575-446-3997
  • Fax:
Mailing address:
  • Phone: 703-945-0504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2023-0695
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: