Organization
LIVE, LLC
Active
Organization
LIVE, LLC
Active
Other names
Live Counseling & Mediation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL W. OLLOM LISW (MEMBER)
(505) 717-7227
Entity
Organization
Contact information
Practice address
4004 CARLISLE BLVD NE STE C6, ALBUQUERQUE, NM 87107-4565
(505) 717-7227
(505) 404-7897
Mailing address
PO BOX 35144, ALBUQUERQUE, NM 87176-5144
(505) 717-7227
(505) 404-7897
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05823
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49626019
—
NM
Enumeration date
09/24/2010
Last updated
12/12/2023
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