Provider Demographics
NPI:1427559772
Name:DAY, THERESA ANN (LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:DAY
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:ANN
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1528 FIVE POINTS RD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-3179
Mailing Address - Country:US
Mailing Address - Phone:505-349-7407
Mailing Address - Fax:
Practice Address - Street 1:1528 FIVE POINTS RD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-3179
Practice Address - Country:US
Practice Address - Phone:505-349-7407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0193191101YM0800X
NMCCMH0217621101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health