Provider Demographics
NPI:1417328303
Name:ALEGRE PSYCHOTHERAPY AND COUNSELING, LLC
Entity Type:Organization
Organization Name:ALEGRE PSYCHOTHERAPY AND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:BUDNIK
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:505-699-7422
Mailing Address - Street 1:8 EL CERRO TRL
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-8090
Mailing Address - Country:US
Mailing Address - Phone:505-699-7422
Mailing Address - Fax:
Practice Address - Street 1:8 EL CERRO TRL
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-8090
Practice Address - Country:US
Practice Address - Phone:505-699-7422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-17
Last Update Date:2015-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-082191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty