Healthcare Provider Details

I. General information

NPI: 1053599050
Provider Name (Legal Business Name): CRAIG JAMES SALISBURY LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 07/30/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7850 JEFFERSON ST NE STE 300
ALBUQUERQUE NM
87109-4314
US

IV. Provider business mailing address

3526 COVERED WAGON RD NE
RIO RANCHO NM
87144-1457
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-2839
  • Fax:
Mailing address:
  • Phone: 505-609-9036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0193481
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: