Provider Demographics
NPI:1326384330
Name:ABERNATHY, DENNIS (LPCC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:ABERNATHY
Suffix:
Gender:M
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:PO BOX 25405
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-0405
Mailing Address - Country:US
Mailing Address - Phone:505-249-7779
Mailing Address - Fax:505-858-2424
Practice Address - Street 1:3150 CARLISLE BLVD NE STE 114
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1681
Practice Address - Country:US
Practice Address - Phone:505-249-7779
Practice Address - Fax:505-858-2424
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0150781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional