MEDICARE: SARA LOMBARDI LPCC

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	CCMH0194131	NM

General Provider Information

NPI Number	:	1578071999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA LOMBARDI LPCC

Provider Business Mailing Address
First Line	:	PO BOX 2732
Second Line	:
City	:	MORIARTY
State	:	NM
Zip	:	87035-2732
Country	:	US
Telephone Number	:	505-433-8822
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 W US ROUTE 66 STE A
Second Line	:
City	:	MORIARTY
State	:	NM
Zip	:	87035-1039
Country	:	US
Telephone Number	:	505-303-9597
Fax Number	:	505-832-4441

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

Provider Enumeration Date	:	01/19/2018
Last Update Date	:	07/15/2021

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Directions to “ SARA LOMBARDI LPCC” Practice Location

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