Healthcare Provider Details

I. General information

NPI: 1679800338
Provider Name (Legal Business Name): MICHELLE P. ESQUIBEL LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2009
Last Update Date: 07/19/2022
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 CARLISLE BLVD NE STE R
ALBUQUERQUE NM
87107-4544
US

IV. Provider business mailing address

PO BOX 36816
ALBUQUERQUE NM
87176-6816
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-5522
  • Fax:
Mailing address:
  • Phone: 505-226-5522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: