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General NPI Number Information
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NPI Number | 1861858698
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Entity Type | Organization
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Legal Business Name | TALKING CIRCLES THERAPY & WELLNESS
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Dates
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Enumeration Date | 01/08/2016
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 4169 MONTGOMERY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-6742
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Country | US
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Telephone | 505-261-9770
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Fax | 505-212-6747
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Provider Business Mailing Address
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Address Line | 4169 MONTGOMERY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-6742
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Country | US
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Telephone | 505-261-9770
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Fax | 505-212-6747
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Authorized Official
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Title or Position | OWNER
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Name | ERIKA NICOLE MARTINEZ-GONZALES
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Credential | LPCC
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Telephone | 505-261-9770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0173531
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License Number State | NM
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