Provider Demographics
NPI:1518707660
Name:AWAKENED HEART COUNSELING
Entity type:Organization
Organization Name:AWAKENED HEART COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPCC
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-920-8938
Mailing Address - Street 1:11120 SIDNEY AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-6318
Mailing Address - Country:US
Mailing Address - Phone:505-920-8938
Mailing Address - Fax:
Practice Address - Street 1:4300 CARLISLE BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4827
Practice Address - Country:US
Practice Address - Phone:505-920-8938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty