Healthcare Provider Details

I. General information

NPI: 1710606603
Provider Name (Legal Business Name): A BETTER PATH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 CARLISLE BLVD NE STE 107
ALBUQUERQUE NM
87110-1663
US

IV. Provider business mailing address

1404 MARCELLA ST NE
ALBUQUERQUE NM
87112-4418
US

V. Phone/Fax

Practice location:
  • Phone: 505-270-6650
  • Fax:
Mailing address:
  • Phone: 505-270-6650
  • 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: MR. EDWARD THOMAS CHURCH
Title or Position: THERAPIST
Credential: LPCC
Phone: 505-270-6650