Provider Demographics
NPI:1770627192
Name:KRIEBLE, INA (LPCC)
Entity Type:Individual
Prefix:
First Name:INA
Middle Name:
Last Name:KRIEBLE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 VISTA DEL SUR ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1546
Mailing Address - Country:US
Mailing Address - Phone:505-450-9271
Mailing Address - Fax:505-873-8489
Practice Address - Street 1:3300 VISTA DEL SUR ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1546
Practice Address - Country:US
Practice Address - Phone:505-450-9271
Practice Address - Fax:505-873-8489
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM006002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM37481541Medicaid
NM89709004Medicaid