Kathleen Luellen Chabot, LPCC

Individual provider Active NPI Professional Counselor · Los Ranchos, NM

NPI 1912201161 · NPPES record last updated Feb 26, 2014

Key facts

NPI
1912201161
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
0141941 (NM)
Practice address
6666 4TH St NW
Suite D
Los Ranchos, NM 87107-6144
Phone
(505) 934-0934
NPI assigned
Jan 3, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0141941NMMDProfessional Counselor
C1498ORMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C1498 OR
Professional Counselor 101YP2500X 0141941 NM Yes

Addresses

Primary practice location

6666 4TH St NW
Suite D
Los Ranchos, NM 87107-6144

Mailing address

4608 Almeria Dr NW
Albuquerque, NM 87120-1840
Phone (505) 934-0934

Other providers in Los Ranchos, NM

All providers in Los Ranchos, NM · Professional Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.