Healthcare Provider Details

I. General information

NPI: 1336480540
Provider Name (Legal Business Name): ANNETTE CRICHTON MS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARQUETTE AVE NW STE 200
ALBUQUERQUE NM
87102-5340
US

IV. Provider business mailing address

PO BOX 671704
DALLAS TX
75267-1704
US

V. Phone/Fax

Practice location:
  • Phone: 505-819-3497
  • Fax:
Mailing address:
  • Phone: 505-819-3497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6528
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: