Provider Demographics
NPI:1356493647
Name:JUDITH FLEISCHMAN & WILLIAM CHAMBREAU, PRTNRS
Entity Type:Organization
Organization Name:JUDITH FLEISCHMAN & WILLIAM CHAMBREAU, PRTNRS
Other - Org Name:PASO NUEVO COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER AND PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBREAU
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW AND LPCC
Authorized Official - Phone:505-247-8853
Mailing Address - Street 1:1803 LOUISIANA BLVD NE
Mailing Address - Street 2:SUITE E-2
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6900
Mailing Address - Country:US
Mailing Address - Phone:505-266-5959
Mailing Address - Fax:505-286-1027
Practice Address - Street 1:1803 LOUISIANA BLVD NE
Practice Address - Street 2:SUITE E-2
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6900
Practice Address - Country:US
Practice Address - Phone:505-266-5959
Practice Address - Fax:505-286-1027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM600398OtherVALUEOPTIONS OF NM