Organization
KERRI WORMWOOD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI FAITH WORMWOOD LPCC, LPAT (CLINICAL COUNSELOR AND ART THERAPIS)
(505) 604-1222
Entity
Organization
Contact information
Practice address
3200 CARLISLE NE, SUITE 204, ALBUQUERQUE, NM 87110
(505) 604-1222
(505) 889-4598
Mailing address
3200 CARLISLE NE, SUITE 204, ALBUQUERQUE, NM 87110
(505) 604-1222
(505) 889-4598
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1129
NM
221700000X
Art Therapist
1128
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000A1775
—
NM
Enumeration date
03/03/2016
Last updated
03/03/2016
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