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General NPI Number Information
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NPI Number | 1205168176
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Entity Type | Organization
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Legal Business Name | GEORGE CHIHA LCSW
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 1010 BRIDGE BLVD SW STE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87105-3765
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Country | US
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Telephone | 505-452-2975
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Fax | 505-277-0139
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Provider Business Mailing Address
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Address Line | PO BOX 28051
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City | SANTA FE
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State | NM
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Zip | 87592-8051
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Country | US
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Telephone | 972-971-1536
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Fax | 505-724-2482
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Authorized Official
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Title or Position | OWNER
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Name | MR. GEORGE CHIHA
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Credential | LCSW
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Telephone | 972-971-1536
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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 | 0095871
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10545
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License Number State | TX
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