Healthcare Provider Details

I. General information

NPI: 1427284959
Provider Name (Legal Business Name): BERJE ADELE BARROW-KAISER PHD,RPP,BCN, , HTC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 11/01/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 RIVAS RD
LOS LUNAS NM
87031-9333
US

IV. Provider business mailing address

1212 RIVAS RD
LOS LUNAS NM
87031-9333
US

V. Phone/Fax

Practice location:
  • Phone: 505-506-2168
  • Fax:
Mailing address:
  • Phone: 505-506-2168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number00000
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number#5363
License Number StateNV
# 6
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCTB-2025-0814
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: