Healthcare Provider Details

I. General information

NPI: 1932132990
Provider Name (Legal Business Name): LOU RAE WOODY LMFT , LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 PASEO DE PERALTA
SANTA FE NM
87501-2233
US

IV. Provider business mailing address

PO BOX 28565
SANTA FE NM
87592-8565
US

V. Phone/Fax

Practice location:
  • Phone: 505-992-3129
  • Fax: 505-820-1209
Mailing address:
  • Phone: 505-992-3129
  • Fax: 505-820-1209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1324
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1325
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: