| Whole Person Counseling Llc | |
|
3321b Candelaria Rd Ne Ste 310 Albuquerque NM 87107-1908 | |
| (505) 699-8440 | |
| (505) 554-3435 |
| Full Name | Whole Person Counseling Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3321b Candelaria Rd Ne Ste 310, Albuquerque, New Mexico |
| Authorized Official Name and Position | Katherine Imislund-clarke (OWNER) |
| Authorized Official Contact | 5056998440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whole Person Counseling Llc Po Box 40354 Albuquerque NM 87196-0354 Ph: (505) 699-8440 | Whole Person Counseling Llc 3321b Candelaria Rd Ne Ste 310 Albuquerque NM 87107-1908 Ph: (505) 699-8440 |
| NPI Number | 1598366056 |
|---|---|
| Provider Enumeration Date | 11/02/2020 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 6800239393 |
|---|---|
| Medicare Enrollment ID | O20240212004025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598366056 | NPI | - | NPPES |
| 41083334 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Katherine Mhc Imislund Clarke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780992107 PECOS PAC ID: 3971941956 Enrollment ID: I20240509000575 |
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