Provider Demographics
NPI:1326324906
Name:ISMAY, KARLA (LPCC)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:ISMAY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830-B MEADOWVIEW DR.
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104
Mailing Address - Country:US
Mailing Address - Phone:505-363-3933
Mailing Address - Fax:
Practice Address - Street 1:1218 GRIEGOS RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-3752
Practice Address - Country:US
Practice Address - Phone:505-345-8471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0143111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health