Healthcare Provider Details

I. General information

NPI: 1326336710
Provider Name (Legal Business Name): MARIAELENA STENDER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 SMEDLEY RD
CARLSBAD NM
88220-9536
US

IV. Provider business mailing address

1213 SMEDLEY RD
CARLSBAD NM
88220-9536
US

V. Phone/Fax

Practice location:
  • Phone: 575-342-1728
  • Fax:
Mailing address:
  • Phone: 575-342-1728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberT-0141081
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: