Healthcare Provider Details
I. General information
NPI: 1124530969
Provider Name (Legal Business Name): 1A COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2017
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4001 OFFICE COURT DR STE 404
SANTA FE NM
87507-4914
US
IV. Provider business mailing address
451 CALLE VOLVER
SANTA FE NM
87505-4244
US
V. Phone/Fax
- Phone: 505-435-8271
- Fax:
- Phone: 915-549-5257
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | 0174291 |
| License Number State | NM |
VIII. Authorized Official
Name:
NICOLE
RENEE
BORSBERRY
Title or Position: OWNER, SINGLE MEMBER
Credential: LPCC
Phone: 915-549-5257