Provider Demographics
NPI:1841478195
Name:GIGANTE, TERESA ARLENE (MA, LPCC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ARLENE
Last Name:GIGANTE
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 CORRALES RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048
Mailing Address - Country:US
Mailing Address - Phone:505-321-1008
Mailing Address - Fax:505-898-5061
Practice Address - Street 1:3949 CORRALES RD
Practice Address - Street 2:SUITE 150
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048
Practice Address - Country:US
Practice Address - Phone:505-321-1008
Practice Address - Fax:505-898-5061
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0109171101YM0800X
NM0126991101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM65672364Medicaid