Provider Demographics
NPI:1346361920
Name:COLBY-SCHMELTZER, CAROLYNNE (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:CAROLYNNE
Middle Name:
Last Name:COLBY-SCHMELTZER
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10516 SIERRA BONITA AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3828
Mailing Address - Country:US
Mailing Address - Phone:505-238-1717
Mailing Address - Fax:505-292-1081
Practice Address - Street 1:3620 WYOMING BLVD NE STE 216
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3289
Practice Address - Country:US
Practice Address - Phone:505-238-1717
Practice Address - Fax:505-292-1081
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2014-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0110811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM57988871Medicaid