| Mind Heart And Soul Counseling Llc | |
|
315 Alameda Blvd Ne Ste A Albuquerque NM 87113-2155 | |
| (505) 220-5809 | |
| Not Available |
| Full Name | Mind Heart And Soul Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 315 Alameda Blvd Ne Ste A, Albuquerque, New Mexico |
| Authorized Official Name and Position | Tyra Jean Russell Fox (CLINICAL MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 5052205809 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Heart And Soul Counseling Llc Po Box 15454 Rio Rancho NM 87174-0454 Ph: (505) 220-5809 | Mind Heart And Soul Counseling Llc 315 Alameda Blvd Ne Ste A Albuquerque NM 87113-2155 Ph: (505) 220-5809 |
| NPI Number | 1689214959 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 01/14/2020 |
| Certification Date | 01/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689214959 | NPI | - | NPPES |
| 56552564 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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