Provider Demographics
NPI:1942713151
Name:UNABRIDGED COUNSELING AND COACHING, LLC
Entity type:Organization
Organization Name:UNABRIDGED COUNSELING AND COACHING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAVONNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCLAY HARROUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-985-8565
Mailing Address - Street 1:7520 MONTGOMERY BLVD NE BLDG E15
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1586
Mailing Address - Country:US
Mailing Address - Phone:505-226-6380
Mailing Address - Fax:505-214-5852
Practice Address - Street 1:7520 MONTGOMERY BLVD NE BLDG E15
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1586
Practice Address - Country:US
Practice Address - Phone:505-226-6380
Practice Address - Fax:505-214-5852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-09259104100000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty