Healthcare Provider Details

I. General information

NPI: 1538907985
Provider Name (Legal Business Name): KORINNA LAUREN CHRISTIAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 UPTOWN BLVD NE STE 305
ALBUQUERQUE NM
87110-4148
US

IV. Provider business mailing address

3712 RIDGE POINTE LOOP NE
ALBUQUERQUE NM
87111-7204
US

V. Phone/Fax

Practice location:
  • Phone: 505-219-1125
  • Fax:
Mailing address:
  • Phone: 505-944-6922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2024-0514
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: