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General NPI Number Information
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NPI Number | 1568949832
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Entity Type | Individual
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Provider Name | INESSA MIL'BERG MA, LPCC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 1421 LUISA ST
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City | SANTA FE
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State | NM
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Zip | 87505-4073
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Country | US
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Telephone | 505-465-9360
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Fax | 505-983-9846
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Provider Business Mailing Address
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Address Line | 28 SETON VILLAGE RD
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City | SANTA FE
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State | NM
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Zip | 87508-8153
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Country | US
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Telephone | 505-670-1759
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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 | CCMH0197531
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License Number State | NM
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