Provider Demographics
NPI:1750550067
Name:STUDENT HEALTH AND COUNSELING
Entity type:Organization
Organization Name:STUDENT HEALTH AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D., DIRECTOR, STUDENT HEALTH CTR
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KLOEPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-277-1068
Mailing Address - Street 1:UNM STUDENT HEALTH AND COUNSELING
Mailing Address - Street 2:MSC06 3870 1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-277-3136
Mailing Address - Fax:505-277-5668
Practice Address - Street 1:UNM STUDENT HEALTH AND COUNSELING
Practice Address - Street 2:MSC06 3870 1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-277-3136
Practice Address - Fax:505-277-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty