Healthcare Provider Details

I. General information

NPI: 1851513212
Provider Name (Legal Business Name): LYNN ANNE LEVEY LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 CARLISLE AVE HEALTHY FAMILIES ABQ
ALBUQUERQUE NM
87106
US

IV. Provider business mailing address

909 TIJERAS AVE NW SUITE 302
ALBUQUERQUE NM
87102-2946
US

V. Phone/Fax

Practice location:
  • Phone: 505-459-2911
  • Fax:
Mailing address:
  • Phone: 575-499-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0125221
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: