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General NPI Number Information
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NPI Number | 1003420696
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Entity Type | Individual
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Provider Name | HEIDI MAE GALL LMHC
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Gender | Female
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 1709 MOON ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-3935
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Country | US
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Telephone | 505-271-4957
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Fax | 505-271-4957
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Provider Business Mailing Address
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Address Line | 729 CAMINO SANTA ANA
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City | SANTA FE
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State | NM
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Zip | 87505-3683
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Country | US
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Telephone | 505-303-8825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | T-CTL0212831
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CTB-2024-0678
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License Number State | NM
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