Anna Balsamo, LPCC
Individual provider Active NPI Professional Counselor · Nambe Pueblo, NM
NPI 1174030902 · NPPES record last updated Jan 17, 2024
Key facts
- NPI
- 1174030902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CCMH0212661 (NM)
- Practice address
- 16A Tayeh Huu U
Nambe Pueblo, NM 87505 - Phone
- (505) 930-2784
- NPI assigned
- Jan 2, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CCMH0212661 | NM | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CCMH0212661 | NM | Yes |
Addresses
Primary practice location
16A Tayeh Huu U
Nambe Pueblo, NM 87505
Mailing address
1726 Agua Fria St
Santa Fe, NM 87505-0980
Phone (207) 216-3272
Other names
- Anna Ingraham
Other providers in Nambe Pueblo, NM
All providers in Nambe Pueblo, NM · Professional Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.