Theresa Susan Kliesen-Maravetz, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0101591 Issued in NM

Practice address

813 Georgia St SE
Albuquerque, NM 87108-4945

Phone

(505) 489-1452

Fax

(505) 232-6682

NPI assigned

Mar 18, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Places to Go LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1265789077
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295859080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 GEORGIA ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084945",
            "telephone_number": "505-489-1452",
            "fax_number": "505-232-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 GEORGIA ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084945",
            "telephone_number": "505-489-1452",
            "fax_number": "505-232-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIESEN-MARAVETZ",
        "first_name": "THERESA",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0101591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Eliezer Klein, DOM
• Hilary Ann Kleinman, MD
• Lisa Kleinstiver, CPSW
• Wesley Jacob Klejch, MD
• Kevin Alexander Kless, M.D.
• Catherine Kline
• Christina Kline, DPT
• Shawn Christoffer Klocek, PA-C
• Beverly Kloeppel, MD
• Carmen Isabella Kloer, MD

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.