Healthcare Provider Details

I. General information

NPI: 1184096190
Provider Name (Legal Business Name): GARY LEE JOSEPH GIRON LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11005 SPAIN RD NE STE 9
ALBUQUERQUE NM
87111-1871
US

IV. Provider business mailing address

5436 TECAMEC RD NE
RIO RANCHO NM
87144-3297
US

V. Phone/Fax

Practice location:
  • Phone: 505-481-9236
  • Fax:
Mailing address:
  • Phone: 505-410-5648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0092241
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: