Healthcare Provider Details

I. General information

NPI: 1043378227
Provider Name (Legal Business Name): PATHFINDER VISIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 11/20/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 BRYN MAWR DR SE
ALBUQUERQUE NM
87106-2206
US

IV. Provider business mailing address

424 BRYN MAWR DR SE
ALBUQUERQUE NM
87106-2206
US

V. Phone/Fax

Practice location:
  • Phone: 505-681-0708
  • Fax: 888-910-5156
Mailing address:
  • Phone: 505-681-0708
  • Fax: 888-910-5156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number93501
License Number StateNM

VIII. Authorized Official

Name: MS. LYDIA S LENNIHAN
Title or Position: OWNER
Credential: LPCC
Phone: 505-681-0708