RAVEN COUNSELING AND WELLNESS LLC NPI 1780911347

NPI Information

NPI: 1780911347
Provider Name: RAVEN COUNSELING AND WELLNESS LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
4601 PARADISE BLVD NW STE G
ALBUQUERQUE, NM
ZIP 87114
Phone: (505) 508-0808
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RAVEN COUNSELING AND WELLNESS LLC is a professional counselor in Albuquerque, NM. RAVEN COUNSELING AND WELLNESS LLC NPI is 1780911347. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4601 PARADISE BLVD NW STE G
ALBUQUERQUE, NM
ZIP 87114-151
Phone: (505) 508-0808
Fax: (888) 896-8728

The provider's authorized official is Julita G Pezzano .
The authorized official title is Owner and has the following contact phone number (505) 508-0808.

The enumeration date for this NPI number is 11/3/2009 and was last updated on 10/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	0100131	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	05959519	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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