Provider Demographics
NPI:1356676605
Name:SZENASI, ROBERT CLAY (LPCC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CLAY
Last Name:SZENASI
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 1:11825 MARQUETTE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1304
Mailing Address - Country:US
Mailing Address - Phone:505-205-2033
Mailing Address - Fax:
Practice Address - Street 1:11825 MARQUETTE AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1304
Practice Address - Country:US
Practice Address - Phone:505-205-2033
Practice Address - Fax:505-247-9503
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0164891101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM71750274Medicaid