MEDICARE: DANIELLE LORRAINE LENZ

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	101YP2500X	Professional Counselor	CTB-2024-0294	NM

General Provider Information

NPI Number	:	1467059428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE LORRAINE LENZ

Provider Business Mailing Address
First Line	:	3 TIERRA DENTRO CT
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-9196
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 COMANCHE RD NE STE 22
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-4546
Country	:	US
Telephone Number	:	505-433-7608
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2020
Last Update Date	:	03/30/2026

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