Organization
JONATHAN MACK COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MACK LPCC (THERAPIST / OWNER)
(505) 385-3963
Entity
Organization
Contact information
Practice address
2727 SAN PEDRO DR NE STE 105, ALBUQUERQUE, NM 87110-3368
(505) 385-3963
(505) 807-9996
Mailing address
2727 SAN PEDRO DR NE STE 105, ALBUQUERQUE, NM 87110-3368
(505) 385-3963
(505) 807-9996
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4272969
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29928753
—
NM
Enumeration date
03/31/2010
Last updated
04/03/2013
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