Healthcare Provider Details

I. General information

NPI: 1447461249
Provider Name (Legal Business Name): REBECCA A LEHNEN LCSW, LADAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 MARQUEZ PL STE 211
SANTA FE NM
87505-1834
US

IV. Provider business mailing address

1012 MARQUEZ PL STE 211
SANTA FE NM
87505-1834
US

V. Phone/Fax

Practice location:
  • Phone: 505-490-2832
  • Fax:
Mailing address:
  • Phone: 505-490-2832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0178651
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-09424
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: