Healthcare Provider Details

I. General information

NPI: 1811229164
Provider Name (Legal Business Name): EDELMIRA FRANCO LPC, LADAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2074 GALISTEO ST STE B4
SANTA FE NM
87505-2157
US

IV. Provider business mailing address

1102 SUNSHINE WAY
SANTA FE NM
87507-9166
US

V. Phone/Fax

Practice location:
  • Phone: 505-501-3683
  • Fax:
Mailing address:
  • Phone: 505-471-3381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0087121
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2094
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: