Healthcare Provider Details

I. General information

NPI: 1942609789
Provider Name (Legal Business Name): LAUREN HUNTER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 LEAD AVE SW
ALBUQUERQUE NM
87102-2987
US

IV. Provider business mailing address

1105 LEAD AVE SW
ALBUQUERQUE NM
87102-2987
US

V. Phone/Fax

Practice location:
  • Phone: 619-997-9637
  • Fax:
Mailing address:
  • Phone: 619-997-9637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCCMH0189191
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: