=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861842577
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TERESA FINLEY LPCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/14/2016
-----------------------------------------------------
Last Update Date | 12/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2900 LOUISIANA BLVD NE SOUTH BUILDING SUITE 210
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87110-3532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-220-8512
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 624
-----------------------------------------------------
City | TAYLORSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-641-2268
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | CCMH0197441
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 0176901
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------