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NPI Code Detail

MEDICARE: LENAN RUST ATR-BC, LPCC, LPAT

MEDICARE: LENAN RUST ATR-BC, LPCC, LPAT
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
1101YP2500XProfessional CounselorLPCC 0104491NM
2101YP2500XProfessional CounselorLPAT 1046NM

General Provider Information

NPI Number : 1386978641
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENAN RUST ATR-BC, LPCC, LPAT
Provider Business Mailing Address
First Line : 212 JEFFERSON ST NE APT A
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-1313
Country : US
Telephone Number : 505-266-7711
Fax Number :
Provider Business Practice Location Address
First Line : 1025 HERMOSA DR SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-4312
Country : US
Telephone Number : 505-266-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2009
Last Update Date : 09/18/2009

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Directions to “ LENAN RUST ATR-BC, LPCC, LPAT” Practice Location

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