Individual
BRENDA BERENICE MEDINA, LPCC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
4730 BECKNER RD, SANTA FE, NM 87507-3691
(505) 989-4500
Mailing address
4730 BECKNER RD, SANTA FE, NM 87507-3691
(505) 989-4500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0126261
NM
101YP2500X
Professional Counselor
Primary
CCMH0159131
NM
Other
Enumeration date
10/28/2009
Last updated
01/22/2024
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