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Organization
JONATHAN WALLACH LPCC LLC
Active
Organization
JONATHAN WALLACH LPCC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONA HOOVER (BILLING SUPERVISOR)
(217) 621-6595
Entity
Organization
Contact information
Practice address
1010 MARQUEZ PL STE C, SANTA FE, NM 87505-1694
(780) 822-6795
Mailing address
13 LOMA SERENA, SANTA FE, NM 87506-7531
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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