Individual
MICAH LYNN BIRDSHIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC (CO); LPCC (NM)
Contact information
Practice address
4730 BECKNER ROAD, SANTA FE, NM 87507
(505) 989-4500
(505) 474-4663
Mailing address
4730 BECKNER ROAD, SANTA FE, NM 87507
(505) 989-4500
(505) 474-4663
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
NLC.0104680
CO
101YP2500X
Professional Counselor
Primary
CCMH0205691
NM
Other
Enumeration date
07/04/2015
Last updated
09/12/2023
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