Healthcare Provider Details

I. General information

NPI: 1336862838
Provider Name (Legal Business Name): TRIPLE SPIRAL COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WASHINGTON AVENUE SUITE 201
SANTA FE NM
87501
US

IV. Provider business mailing address

150 WASHINGTON AVENUE SUITE 201, PMB 4689
SANTA FE NM
87501-2038
US

V. Phone/Fax

Practice location:
  • Phone: 575-425-0640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHLEEN M SHARKEY
Title or Position: OWNER
Credential: LPCC
Phone: 505-450-1542