Healthcare Provider Details

I. General information

NPI: 1033445531
Provider Name (Legal Business Name): LISTENING SAGE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2009
Last Update Date: 10/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 MESA VISTA ST
SANTA FE NM
87501-1732
US

IV. Provider business mailing address

PO BOX 31254
SANTA FE NM
87594-1254
US

V. Phone/Fax

Practice location:
  • Phone: 505-820-2433
  • Fax: 505-984-9974
Mailing address:
  • Phone: 505-820-2433
  • Fax: 505-984-9974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3020
License Number StateNM

VIII. Authorized Official

Name: DR. LEONA K STUCKY-ABBOTT
Title or Position: PASTORAL COUNSELOR, PSYCHOTHERAPIST
Credential: D. MIN
Phone: 505-820-2433