Healthcare Provider Details

I. General information

NPI: 1790433019
Provider Name (Legal Business Name): HEIDI NEFF LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5916 ANAHEIM AVE NE
ALBUQUERQUE NM
87113-1887
US

IV. Provider business mailing address

3508 CALLE DEL RANCHERO NE
ALBUQUERQUE NM
87106-1233
US

V. Phone/Fax

Practice location:
  • Phone: 505-291-6314
  • Fax:
Mailing address:
  • Phone: 717-344-3642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2022-0018
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: