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General NPI Number Information
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NPI Number | 1275884785
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Entity Type | Individual
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Provider Name | MARCOS A REYNA LPCC
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Gender | Male
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 06/08/2024
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Provider Practice Location Address
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Address Line | 8300 CONSTITUTION AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7613
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Country | US
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Telephone | 505-291-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | HATCH
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State | NM
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Zip | 87937-0370
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Country | US
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Telephone | 575-267-3280
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Fax | 575-267-1747
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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 | 0177811
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0169001
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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 | P84090
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CCMH0177811
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License Number State | NM
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