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General NPI Number Information
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NPI Number | 1609107861
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Entity Type | Individual
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Provider Name | ANTHONY PAUL SMARRELLA LPCC
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Gender | Male
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 2418 MILES RD SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-3224
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Country | US
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Telephone | 505-228-5488
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Fax | 505-286-1653
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Provider Business Mailing Address
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Address Line | PO BOX 1175
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City | TIJERAS
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State | NM
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Zip | 87059-1175
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Country | US
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Telephone | 505-228-5488
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Fax | 505-286-1653
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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 | 0083641
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License Number State | NM
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