Provider Demographics
NPI:1821477852
Name:WELLBEING COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:WELLBEING COUNSELING CENTER, LLC
Other - Org Name:NAMASTE CIRCLE FOR SPIRITUAL LIVING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:A L
Authorized Official - Last Name:BRAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-301-9997
Mailing Address - Street 1:1021 ARIZONA ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-4827
Mailing Address - Country:US
Mailing Address - Phone:505-918-6692
Mailing Address - Fax:505-672-7916
Practice Address - Street 1:3636 MENAUL BLVD. NE
Practice Address - Street 2:SUITE 102
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2842
Practice Address - Country:US
Practice Address - Phone:505-301-9997
Practice Address - Fax:505-672-7916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-07338101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM89239814Medicaid
NMPTAN: 390801Medicare PIN