Provider Demographics
NPI:1144235896
Name:GIUDICI, PAOLO (LPCC, LADAC)
Entity Type:Individual
Prefix:
First Name:PAOLO
Middle Name:
Last Name:GIUDICI
Suffix:
Gender:M
Credentials:LPCC, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6604
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502
Mailing Address - Country:US
Mailing Address - Phone:505-466-1764
Mailing Address - Fax:501-421-3119
Practice Address - Street 1:1925 ASPEN DRIVE
Practice Address - Street 2:SUITE 700B
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-466-1764
Practice Address - Fax:501-421-3119
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0413101Y00000X
NM3478101YA0400X
CO1865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM79907Medicaid
NM79895Medicaid