Provider Demographics
NPI:1215382890
Name:SHELLEY EULER-BEAUDET MA LPCC NCC
Entity Type:Organization
Organization Name:SHELLEY EULER-BEAUDET MA LPCC NCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:EULER-BEAUDET
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPCC NCC
Authorized Official - Phone:505-980-0142
Mailing Address - Street 1:12813 BRYCE CT NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-4807
Mailing Address - Country:US
Mailing Address - Phone:505-980-0142
Mailing Address - Fax:505-275-8476
Practice Address - Street 1:12813 BRYCE CT NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-4807
Practice Address - Country:US
Practice Address - Phone:505-980-0142
Practice Address - Fax:505-275-8476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0434261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center