Healthcare Provider Details

I. General information

NPI: 1972334209
Provider Name (Legal Business Name): SATDARSHAN KAUR KHALSA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 CARDENAS DR SE
ALBUQUERQUE NM
87108-4806
US

IV. Provider business mailing address

920 CARDENAS DR SE
ALBUQUERQUE NM
87108-4806
US

V. Phone/Fax

Practice location:
  • Phone: 505-266-8168
  • Fax:
Mailing address:
  • Phone: 505-927-7386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB20240091
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: