Provider Demographics
NPI:1437728490
Name:CARMEN ULIBARRI, LPCC
Entity Type:Organization
Organization Name:CARMEN ULIBARRI, LPCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ULIBARRI
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-429-3241
Mailing Address - Street 1:2313 HOT SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-3734
Mailing Address - Country:US
Mailing Address - Phone:505-429-3241
Mailing Address - Fax:
Practice Address - Street 1:2313 HOT SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-3734
Practice Address - Country:US
Practice Address - Phone:505-429-3241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM80321704Medicaid