Provider Demographics
NPI:1639892391
Name:ALPENGLOW COUNSELING, LLC
Entity Type:Organization
Organization Name:ALPENGLOW COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERSTAD-RAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-336-1543
Mailing Address - Street 1:99 ALTEZA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-2219
Mailing Address - Country:US
Mailing Address - Phone:505-336-1543
Mailing Address - Fax:
Practice Address - Street 1:3 CALIENTE RD STE 10
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-9209
Practice Address - Country:US
Practice Address - Phone:505-336-1543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty