Individual
TATIA O LIPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, ACCTS
Contact information
Practice address
4141 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-6741
(505) 560-2804
Mailing address
6424 AVENIDA SEVILLE NW, ALBUQUERQUE, NM 87114-3765
(575) 317-8717
(575) 208-0325
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0122711
NM
1041C0700X
Clinical Social Worker
Primary
C-07992
NM
1041C0700X
Clinical Social Worker
I-07992
NM
Other
Enumeration date
11/08/2008
Last updated
09/10/2022
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