Healthcare Provider Details

I. General information

NPI: 1043742620
Provider Name (Legal Business Name): TAHZEEB GILLANI LMFT,LPC,NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 4TH ST NW STE 102
ALBUQUERQUE NM
87102-2104
US

IV. Provider business mailing address

500 4TH ST NW STE 102
ALBUQUERQUE NM
87102-2104
US

V. Phone/Fax

Practice location:
  • Phone: 505-818-8905
  • Fax:
Mailing address:
  • Phone: 505-818-8905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT.0002004
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberCTB-2025-0684
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC.0016272
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: