Healthcare Provider Details

I. General information

NPI: 1992195093
Provider Name (Legal Business Name): REDWOOD COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 GRACELAND, S.E. SUITE A
ALBUQUERQUE NM
87108
US

IV. Provider business mailing address

PO BOX 4339
ALBUQUERQUE NM
87106
US

V. Phone/Fax

Practice location:
  • Phone: 505-261-0952
  • Fax:
Mailing address:
  • Phone: 505-261-0952
  • 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: SONDRA REDWOOD
Title or Position: PRESIDENT
Credential: MA, LPCC, LADAC
Phone: 505-261-0952