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Organization

LISA ANN CELOSSE

Active
Other names
Lisa Ann Celosse
Organization subpart
No

Provider details

NPI number
Authorized official
LISA A CELOSSE LPCC, LMFT (LPCC. LMFT)
(505) 720-9167
Entity
Organization

Contact information

Practice address
1925 ASPEN DR STE 302A, SANTA FE, NM 87505-5588
(505) 720-9167
Mailing address
PO BOX 250, CHIMAYO, NM 87522-0250
(505) 720-9167

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
0091031
NM
251S00000X
Community/Behavioral Health Agency
Primary
0104011
NM
251S00000X
Community/Behavioral Health Agency
MFC38644
CA

Other

Enumeration date
12/17/2010
Last updated
12/17/2010
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