MEDICARE: AVERY LEIGH BARNARD

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	CTB20240817	NM

General Provider Information

NPI Number	:	1609368976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVERY LEIGH BARNARD

Provider Business Mailing Address
First Line	:	524 MISSION AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-4906
Country	:	US
Telephone Number	:	505-440-9501
Fax Number	:

Provider Business Practice Location Address
First Line	:	6330 RIVERSIDE PLAZA LN NW STE 260
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2160
Country	:	US
Telephone Number	:	505-226-2839
Fax Number	:	505-295-2559

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

Provider Enumeration Date	:	06/03/2018
Last Update Date	:	12/16/2024

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Directions to “ AVERY LEIGH BARNARD ” Practice Location

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