Healthcare Provider Details

I. General information

NPI: 1841478195
Provider Name (Legal Business Name): TERESA ARLENE GIGANTE MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 10/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 CORRALES RD SUITE 150
CORRALES NM
87048
US

IV. Provider business mailing address

3949 CORRALES RD SUITE 150
CORRALES NM
87048
US

V. Phone/Fax

Practice location:
  • Phone: 505-321-1008
  • Fax: 505-898-5061
Mailing address:
  • Phone: 505-321-1008
  • Fax: 505-898-5061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberT-0109171
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0126991
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: