Edward Thomas Church III, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0085761 Issued in NM

Practice address

1330 San Pedro Dr NE
Suite 201B
Albuquerque, NM 87110-6744

Phone

(505) 260-9912

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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.

• A Better Path Counseling, LLC

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1710606603
  NPD Authorized official
• A New Day Inc.

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1134134885
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1891862462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 BLUE RIDGE PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871114168",
            "telephone_number": "505-299-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SAN PEDRO DR NE",
            "address_2": "SUITE 201B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871106744",
            "telephone_number": "505-260-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0085761",
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0085761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tzu-Han Chung
• Janet Hang Chuong
• Cynthia Churan, SLP
• Leslie Churan, RN
• Barbara L Church, LPCC
• Lauren Church
• Shandiin A Church
• Jennifer Lee Churchill, CNP
• Kimberly Chwojdak
• Cielos Abiertos

• 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 Sep 18, 2013; 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.