Healthcare Provider Details

I. General information

NPI: 1629785019
Provider Name (Legal Business Name): MELISSA SPAMER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 11/04/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 CAMINO DE MONTE REY STE B3
SANTA FE NM
87505-3961
US

IV. Provider business mailing address

2812 MOLINO DE VIENTO
SANTA FE NM
87505-6436
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-1835
  • Fax: 505-230-2033
Mailing address:
  • Phone: 505-913-1835
  • Fax: 505-230-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: