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General NPI Number Information
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NPI Number | 1114213246
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Entity Type | Organization
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Legal Business Name | RASMUSSEN COUNSELING LLC
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 2901 JUAN TABO BLVD NE SUITE 121-E
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-1886
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Country | US
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Telephone | 505-263-9375
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21182
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City | ALBUQUERQUE
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State | NM
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Zip | 87154-1182
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Country | US
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Telephone | 505-263-9375
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. MARTIN RASMUSSEN
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Credential |
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Telephone | 505-263-9375
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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 | 2686
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License Number State | NM
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