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General NPI Number Information
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NPI Number | 1255636585
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Entity Type | Individual
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Provider Name | SHERWIN KEITH PRICE LPCC
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Gender | Male
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 801 ENCINO PL NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2612
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Country | US
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Telephone | 505-272-2573
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Fax |
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Provider Business Mailing Address
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Address Line | 2441 CABEZON BLVD SE
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City | RIO RANCHO
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State | NM
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Zip | 87124
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Country | US
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Telephone | 505-717-1155
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Fax | 505-717-1473
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0164601
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CCMH0184991
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CCMH0184991
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | NM
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