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NPI Code Detail

MEDICARE: NILES HEWLETT LPCC, LCMHC

MEDICARE: NILES HEWLETT LPCC, LCMHC
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 Counselor

General Provider Information

NPI Number : 1942668629
Entity Type Code : Individual
Provider Name (Legal Business Name) : NILES HEWLETT LPCC, LCMHC
Provider Business Mailing Address
First Line : 1 LLANITO RD
Second Line :
City : BERNALILLO
State : NM
Zip : 87004-9701
Country : US
Telephone Number : 505-895-1914
Fax Number :
Provider Business Practice Location Address
First Line : 901 RIO GRANDE BLVD NW STE G252
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87104-2050
Country : US
Telephone Number : 505-702-8112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2016
Last Update Date : 11/20/2025

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