# INNER PEAK YOUTH COUNSELING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386138451
- **Authorized official:** MR. JASON WADE BURNEY LPCC (CEO)
- **Authorized official phone:** (505) 600-5803

## Contact information

- **Practice address:** 11000 CANDELARIA RD NE, ALBUQUERQUE, NM 87112-1751
- **Practice address phone:** (505) 600-5803
- **Mailing address:** 1125 KENTUCKY ST SE, ALBUQUERQUE, NM 87108-4942
- **Mailing address phone:** (505) 600-5803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/21/2018
- **Last updated:** 06/21/2018