Provider Demographics
NPI:1164544607
Name:BUGEL, ANNE HARRIETTE (LCSW, MDIV)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:HARRIETTE
Last Name:BUGEL
Suffix:
Gender:F
Credentials:LCSW, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 VAIL AVE SE APT C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1666
Mailing Address - Country:US
Mailing Address - Phone:828-712-8278
Mailing Address - Fax:
Practice Address - Street 1:3539 THAXTON AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:828-712-8278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9760101YM0800X
101YP1600X
GACSW0033151041C0700X
NCC0048261041C0700X
NMC-107641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral