Healthcare Provider Details

I. General information

NPI: 1386851665
Provider Name (Legal Business Name): TERRI RAE ABRAHAM LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10405 CONSTITUTION AVE NE
ALBUQUERQUE NM
87112-5421
US

IV. Provider business mailing address

10405 CONSTITUTION AVE NE
ALBUQUERQUE NM
87112-5421
US

V. Phone/Fax

Practice location:
  • Phone: 505-275-1959
  • Fax: 505-224-3261
Mailing address:
  • Phone: 505-275-1959
  • Fax: 505-224-3261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0083811
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number22063
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: