Provider Demographics
NPI:1407867609
Name:KENNEDY-CURL, ALYCE (LPCC)
Entity Type:Individual
Prefix:
First Name:ALYCE
Middle Name:
Last Name:KENNEDY-CURL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:ALYCE
Other - Middle Name:
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3200 CARLISLE BLVD. NE
Mailing Address - Street 2:SUITE 222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1600
Mailing Address - Country:US
Mailing Address - Phone:505-889-4584
Mailing Address - Fax:505-867-2383
Practice Address - Street 1:3200 CARLISLE BLVD NE
Practice Address - Street 2:SUITE 222
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1600
Practice Address - Country:US
Practice Address - Phone:505-889-4584
Practice Address - Fax:505-867-7293
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLMHC: 0077181101Y00000X
NMMD: 87-91207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM65808363Medicaid