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Individual

STACY ERTLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPCC

Contact information

Practice address
6501 CYPRESS POINT WAY NE, ALBUQUERQUE, NM 87111-6411
(505) 379-1550
(800) 714-4705
Mailing address
6501 CYPRESS POINT WAY NE, ALBUQUERQUE, NM 87111-6411
(505) 379-1550
(800) 714-4705

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11798371
CAQH
01
NM000105
VALUE OPTIONS OF NM #
NM
Enumeration date
08/30/2006
Last updated
06/15/2010
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