Provider Demographics
NPI:1952469678
Name:POLITO, MARGARET MARY (MA LPCC)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MARY
Last Name:POLITO
Suffix:
Gender:F
Credentials:MA LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4233 MONTGOMERY NE
Mailing Address - Street 2:STE 200 W
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6707
Mailing Address - Country:US
Mailing Address - Phone:505-884-8040
Mailing Address - Fax:
Practice Address - Street 1:4233 MONTGOMERY NE
Practice Address - Street 2:STE 200 W
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6707
Practice Address - Country:US
Practice Address - Phone:505-884-8040
Practice Address - Fax:505-884-3230
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2015101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM100589Medicaid