Healthcare Provider Details

I. General information

NPI: 1366577819
Provider Name (Legal Business Name): ELAINE WARD GIOVANDO LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ELAINE WARD SCHUCHARD

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 GALISTEO ST SUITE N2
SANTA FE NM
87505
US

IV. Provider business mailing address

32 DOUBLE ARROW RD
SANTA FE NM
87505
US

V. Phone/Fax

Practice location:
  • Phone: 505-310-0782
  • Fax:
Mailing address:
  • Phone: 505-988-1916
  • Fax: 505-988-1916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0080041
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: