Provider Demographics
NPI:1184399958
Name:ARCO IRIS ABQ COUNSELING, LLC
Entity type:Organization
Organization Name:ARCO IRIS ABQ COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUERAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:505-418-1755
Mailing Address - Street 1:6300 RIVERSIDE PLAZA LN NW STE 100
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1908
Mailing Address - Country:US
Mailing Address - Phone:505-418-1755
Mailing Address - Fax:
Practice Address - Street 1:4425 JUAN TABO BLVD NE STE 220
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2681
Practice Address - Country:US
Practice Address - Phone:505-418-1755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty