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General NPI Number Information
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NPI Number | 1598366056
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Entity Type | Organization
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Legal Business Name | WHOLE PERSON COUNSELING LLC
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 3321B CANDELARIA RD NE STE 310
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-1908
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Country | US
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Telephone | 505-699-8440
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Fax | 505-554-3435
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Provider Business Mailing Address
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Address Line | PO BOX 40354
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City | ALBUQUERQUE
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State | NM
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Zip | 87196-0354
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Country | US
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Telephone | 505-699-8440
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE IMISLUND-CLARKE
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Credential | LPCC
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Telephone | 505-699-8440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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