Provider Demographics
NPI:1700993276
Name:SCHALHOUB, RICHARD G (MA LPCC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:SCHALHOUB
Suffix:
Gender:M
Credentials:MA LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8338 COMANCHE ROAD NE SUITE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2357
Mailing Address - Country:US
Mailing Address - Phone:505-259-1086
Mailing Address - Fax:
Practice Address - Street 1:8338 COMANCHE ROAD NE SUITE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2357
Practice Address - Country:US
Practice Address - Phone:505-259-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000B8922Medicaid