Healthcare Provider Details

I. General information

NPI: 1437526522
Provider Name (Legal Business Name): SARAH SUZANNE SHAH MA, LMHC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12836 LOMAS BLVD NE STE C
ALBUQUERQUE NM
87112-6200
US

IV. Provider business mailing address

12836 LOMAS BLVD NE STE C
ALBUQUERQUE NM
87112-6200
US

V. Phone/Fax

Practice location:
  • Phone: 505-710-6530
  • Fax: 505-227-8993
Mailing address:
  • Phone: 505-710-6530
  • Fax: 505-227-8993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCMH0203921
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: