Healthcare Provider Details

I. General information

NPI: 1043460249
Provider Name (Legal Business Name): LINDA L. MACQUIGG LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 CASA RUFINA RD. #705
SANTA FE NM
87507-8300
US

IV. Provider business mailing address

2502 CAMINO ENTRADA
SANTA FE NM
87507-4911
US

V. Phone/Fax

Practice location:
  • Phone: 505-474-5281
  • Fax:
Mailing address:
  • Phone: 505-471-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0106291
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: