Healthcare Provider Details

I. General information

NPI: 1972668093
Provider Name (Legal Business Name): CHERYL ANNE SPAHR MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 EUBANK BLVD NE STE 6
ALBUQUERQUE NM
87112-5300
US

IV. Provider business mailing address

616 VIA POSADA SE
ALBUQUERQUE NM
87123-4510
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-1554
  • Fax:
Mailing address:
  • Phone: 505-292-0031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberM1116
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: