Healthcare Provider Details

I. General information

NPI: 1760261416
Provider Name (Legal Business Name): KULDEEP KAUR LCSW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2023
Last Update Date: 11/18/2023
Certification Date: 11/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 HAMPTON AVE NE
ALBUQUERQUE NM
87122-2956
US

IV. Provider business mailing address

8900 HAMPTON AVE NE
ALBUQUERQUE NM
87122-2956
US

V. Phone/Fax

Practice location:
  • Phone: 559-942-0776
  • Fax:
Mailing address:
  • Phone: 559-942-0776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KULDEEP KAUR
Title or Position: PRESIDENT
Credential: LCSW
Phone: 559-942-0776