Organization
INNER PEAK YOUTH COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON WADE BURNEY LPCC (CEO)
(505) 600-5803
Entity
Organization
Contact information
Practice address
11000 CANDELARIA RD NE, ALBUQUERQUE, NM 87112-1751
(505) 600-5803
Mailing address
1125 KENTUCKY ST SE, ALBUQUERQUE, NM 87108-4942
(505) 600-5803
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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