| Robert Kevin Hennelly, Lppc, Llc | |
|
2205 Miguel Chavez Rd Ste F Santa Fe NM 87505-1111 | |
| (505) 629-7108 | |
| Not Available |
| Full Name | Robert Kevin Hennelly, Lppc, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2205 Miguel Chavez Rd Ste F, Santa Fe, New Mexico |
| Authorized Official Name and Position | Robert K Hennelly (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5056297108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Kevin Hennelly, Lppc, Llc 2916 Calle Derecha Santa Fe NM 87505-6530 Ph: (505) 629-7108 | Robert Kevin Hennelly, Lppc, Llc 2205 Miguel Chavez Rd Ste F Santa Fe NM 87505-1111 Ph: (505) 629-7108 |
| NPI Number | 1073103552 |
|---|---|
| Provider Enumeration Date | 01/19/2021 |
| Last Update Date | 01/19/2021 |
| Certification Date | 01/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073103552 | NPI | - | NPPES |
| 25087827 | Medicaid | NM |
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