Provider Demographics
NPI:1366577819
Name:GIOVANDO, ELAINE WARD (LPCC)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:WARD
Last Name:GIOVANDO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MISS
Other - First Name:ELAINE
Other - Middle Name:WARD
Other - Last Name:SCHUCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32 DOUBLE ARROW RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505
Mailing Address - Country:US
Mailing Address - Phone:505-988-1916
Mailing Address - Fax:505-988-1916
Practice Address - Street 1:2019 GALISTEO ST
Practice Address - Street 2:SUITE N2
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-310-0782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0080041101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM97076261Medicaid
NMWM000180CTOtherVALUE OPTIONS