Healthcare Provider Details

I. General information

NPI: 1265791685
Provider Name (Legal Business Name): JENNIFER LEE SCHOUMAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 MOON ST NE
ALBUQUERQUE NM
87112-3935
US

IV. Provider business mailing address

1709 MOON ST NE
ALBUQUERQUE NM
87112-3935
US

V. Phone/Fax

Practice location:
  • Phone: 505-418-2727
  • Fax:
Mailing address:
  • Phone: 505-418-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0148111
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: