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General NPI Number Information
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NPI Number | 1255896353
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Entity Type | Organization
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Legal Business Name | 32 DEGREES GENUINE, LLC
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 5701 CARMEL AVE NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2843
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Country | US
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Telephone | 505-308-5226
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Fax | 505-514-0754
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Provider Business Mailing Address
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Address Line | 5701 CARMEL AVE NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2843
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Country | US
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Telephone | 505-595-6622
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Fax | 505-514-0754
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | JESSICA R JOHNSON
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Credential | LPCC
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Telephone | 505-595-6622
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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 |
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License Number State |
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