| Live Counseling & Mediation | |
|
4004 Carlisle Blvd Ne Ste C6 Albuquerque NM 87107-4565 | |
| (505) 717-7227 | |
| (505) 404-7897 |
| Full Name | Live Counseling & Mediation |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4004 Carlisle Blvd Ne Ste C6, Albuquerque, New Mexico |
| Authorized Official Name and Position | Michael W. Ollom (MEMBER) |
| Authorized Official Contact | 5057177227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Counseling & Mediation Po Box 35144 Albuquerque NM 87176-5144 Ph: (505) 717-7227 | Live Counseling & Mediation 4004 Carlisle Blvd Ne Ste C6 Albuquerque NM 87107-4565 Ph: (505) 717-7227 |
| NPI Number | 1275842254 |
|---|---|
| Provider Enumeration Date | 09/24/2010 |
| Last Update Date | 12/12/2023 |
| Certification Date | 12/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275842254 | NPI | - | NPPES |
| 49626019 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I-05823 (New Mexico) | Primary |
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