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General NPI Number Information
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NPI Number | 1548037211
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Entity Type | Organization
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Legal Business Name | NEUROO COUNSELING LLC
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 9400 HOLLY AVE NE BLDG 4
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2969
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Country | US
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Telephone | 505-886-1381
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Fax |
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Provider Business Mailing Address
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Address Line | 508 ARAGON ST SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-4505
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Country | US
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Telephone | 505-886-1381
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL SUPERVISOR
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Name | HEATHER GEORGIEFF
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Credential | LPCC
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Telephone | 505-886-1381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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