MEDICARE: SHELLEY EULER-BEAUDET MA LPCC NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	0434	NM

General Provider Information

NPI Number	:	1215382890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELLEY EULER-BEAUDET MA LPCC NCC

Provider Business Mailing Address
First Line	:	12813 BRYCE CT NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-4807
Country	:	US
Telephone Number	:	505-980-0142
Fax Number	:	505-275-8476

Provider Business Practice Location Address
First Line	:	12813 BRYCE CT NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-4807
Country	:	US
Telephone Number	:	505-980-0142
Fax Number	:	505-275-8476

Authorized Official
Title or Position	:	COUNSELOR
Name	:	SHELLEY JO EULER-BEAUDET
Credential	:	MA LPCC NCC
Telephone Number	:	505-980-0142

Provider Enumeration Date	:	05/02/2016
Last Update Date	:	05/02/2016

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