Healthcare Provider Details

I. General information

NPI: 1801274527
Provider Name (Legal Business Name): MICHEL LEGER LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 SAN PEDRO DR NE STE 203
ALBUQUERQUE NM
87110-4122
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-414-7721
  • Fax: 678-426-6620
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0172491
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: