Healthcare Provider Details

I. General information

NPI: 1174980353
Provider Name (Legal Business Name): JUNIPER COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 07/19/2025
Certification Date: 07/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 WYOMING BLVD NE STE 212
ALBUQUERQUE NM
87112-1033
US

IV. Provider business mailing address

2601 WYOMING BLVD NE STE 212
ALBUQUERQUE NM
87112-1033
US

V. Phone/Fax

Practice location:
  • Phone: 505-619-3258
  • Fax:
Mailing address:
  • Phone: 505-619-3258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-07643
License Number StateNM

VIII. Authorized Official

Name: JESSICA RAAB SCHNEIDER
Title or Position: LCSW/MANAGER
Credential: LCSW
Phone: 505-619-3258