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General NPI Number Information
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NPI Number | 1467059428
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Entity Type | Individual
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Provider Name | DANIELLE LORRAINE LENZ
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Gender | Female
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 6121 INDIAN SCHOOL RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4140
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Country | US
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Telephone | 505-463-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 7 APACHE PLUME RD
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City | LOS LUNAS
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State | NM
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Zip | 87031-9545
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CMH0219701
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CTB-2024-0294
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License Number State |
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