MEDICARE: MS. SUSAN ANNE HONORE JEAN-PIERRE M.A., L.M.H.C

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	101YM0800X	Mental Health Counselor	3420	NM

General Provider Information

NPI Number	:	1578783908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN ANNE HONORE JEAN-PIERRE M.A., L.M.H.C

Provider Business Mailing Address
First Line	:	324 ADAMS ST SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-2837
Country	:	US
Telephone Number	:	505-969-5999
Fax Number	:

Provider Business Practice Location Address
First Line	:	324 ADAMS ST SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-2837
Country	:	US
Telephone Number	:	505-969-5999
Fax Number	:

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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