Healthcare Provider Details

I. General information

NPI: 1528148442
Provider Name (Legal Business Name): NANCY NORDYKE ISBELL LPCC,NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 WYOMING BLVD, NE, SUITE 202
ALBUQUERQUE NM
87112-0000
US

IV. Provider business mailing address

2341 GENERAL BRADLEY, NE
ALBUQUERQUE NM
87112
US

V. Phone/Fax

Practice location:
  • Phone: 505-220-9329
  • Fax:
Mailing address:
  • Phone: 505-220-9329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2963
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: