Healthcare Provider Details

I. General information

NPI: 1972332443
Provider Name (Legal Business Name): SACRED CONNECTIONS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 MORNINGSIDE DR NE
ALBUQUERQUE NM
87110-4926
US

IV. Provider business mailing address

1826 MORNINGSIDE DR NE
ALBUQUERQUE NM
87110-4926
US

V. Phone/Fax

Practice location:
  • Phone: 505-489-7170
  • Fax:
Mailing address:
  • Phone: 505-489-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: WANNI ZHOU
Title or Position: OWNER
Credential:
Phone: 505-489-7170