Provider Demographics
NPI:1922260397
Name:KELEHER, JULIA ROSE (LPCC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:KELEHER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:KELEHER
Other - Last Name:DINEEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:THREE HEARTS THERAPY, LLC
Mailing Address - Street 2:2201 SAN PEDRO DR NE, BLDG #2, SUITE #100
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110
Mailing Address - Country:US
Mailing Address - Phone:505-265-0753
Mailing Address - Fax:
Practice Address - Street 1:2201 SAN PEDRO DR NE, BLDG #2, SUITE #100
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-265-0753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0066852101YM0800X
NMCTB-2022-0919101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health