Healthcare Provider Details

I. General information

NPI: 1316937956
Provider Name (Legal Business Name): THOMAS EDWARD WELTER MC LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1474 SOUTH ST FRANCIS DRIVE
SANTA FE NM
87505
US

IV. Provider business mailing address

1474 SOUTH ST FRANCIS DRIVE
SANTA FE NM
87505
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-5504
  • Fax: 505-988-5504
Mailing address:
  • Phone: 505-988-5504
  • Fax: 505-988-5504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2906
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2906
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: