Healthcare Provider Details

I. General information

NPI: 1023096872
Provider Name (Legal Business Name): STEVEN ANDREW WASHBURN PHD, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 GEORGIA ST NE SUITE B 2
ALBUQUERQUE NM
87110-1359
US

IV. Provider business mailing address

3901 GEORGIA ST NE SUITE B 2
ALBUQUERQUE NM
87110-1359
US

V. Phone/Fax

Practice location:
  • Phone: 505-837-1177
  • Fax: 505-872-8045
Mailing address:
  • Phone: 505-837-1177
  • Fax: 505-872-8045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0404
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-1658
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: