Healthcare Provider Details

I. General information

NPI: 1497299788
Provider Name (Legal Business Name): ABELLA COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2016
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE NM
87120-1908
US

IV. Provider business mailing address

6300 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE NM
87120-1908
US

V. Phone/Fax

Practice location:
  • Phone: 505-440-1726
  • Fax: 505-796-9601
Mailing address:
  • Phone: 505-440-1726
  • Fax: 505-796-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0158421
License Number StateNM

VIII. Authorized Official

Name: HEATHER ABELLA
Title or Position: OWNER/MENTAL HEALTH COUNSELOR
Credential: MA, LPCC
Phone: 505-440-1726