Provider Demographics
NPI:1346707601
Name:ULIBARRI, CARMEN (LPCC)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:ULIBARRI
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 1:2313 HOT SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-3734
Mailing Address - Country:US
Mailing Address - Phone:505-425-2913
Mailing Address - Fax:505-425-2913
Practice Address - Street 1:2313 HOT SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-3734
Practice Address - Country:US
Practice Address - Phone:505-425-2913
Practice Address - Fax:505-425-2913
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0197521101YM0800X
NMCCMH0216761101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMCMH0197521OtherREGULATION AND LICENSING DEPARTMENT
NMCCMH0216761OtherREGULATION AND LICENSING DEPARTMENT