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General NPI Number Information
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NPI Number | 1235481201
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Entity Type | Organization
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Legal Business Name | JOURNEYS COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 111 GOLD AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-3430
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Country | US
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Telephone | 505-715-7541
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Fax |
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Provider Business Mailing Address
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Address Line | 111 GOLD AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-3430
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Country | US
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Telephone | 505-715-7541
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ALICE L OTERO-ARMIJO
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Credential | LPCC
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Telephone | 505-715-7541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0136091
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License Number State | NM
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