Provider Demographics
NPI:1770713059
Name:WEBER, NELDA SUE (LPCC)
Entity type:Individual
Prefix:MS
First Name:NELDA
Middle Name:SUE
Last Name:WEBER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 OLD MILL RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-6392
Mailing Address - Country:US
Mailing Address - Phone:505-994-3405
Mailing Address - Fax:
Practice Address - Street 1:3533 OLD MILL RD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-6392
Practice Address - Country:US
Practice Address - Phone:505-994-3405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0121701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health