Provider Demographics
NPI:1811012099
Name:KIRKPATRICK, ANN EIZABETH (LPC,LPCC PENDING)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:EIZABETH
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:LPC,LPCC PENDING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 EL REY DR
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-7117
Mailing Address - Country:US
Mailing Address - Phone:505-269-0490
Mailing Address - Fax:505-897-0419
Practice Address - Street 1:159 EL REY DRIVE
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-7117
Practice Address - Country:US
Practice Address - Phone:505-269-0490
Practice Address - Fax:505-897-0419
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLPC 401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional