Healthcare Provider Details

I. General information

NPI: 1720110174
Provider Name (Legal Business Name): RISA LEHRER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 PUEBLO RD
EL PRADO NM
87529-4506
US

IV. Provider business mailing address

13 PUEBLO RD
EL PRADO NM
87529-4506
US

V. Phone/Fax

Practice location:
  • Phone: 575-758-3913
  • Fax:
Mailing address:
  • Phone: 575-758-3913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberNMT0113881
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number116051
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0094871
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: