Provider Demographics
NPI:1104563956
Name:DREAMLIFE COUNSELING LLC
Entity type:Organization
Organization Name:DREAMLIFE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-257-6868
Mailing Address - Street 1:1933 SAN MATEO BLVD NE # 222
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5146
Mailing Address - Country:US
Mailing Address - Phone:505-257-6868
Mailing Address - Fax:
Practice Address - Street 1:1664 VIA BOSQUE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87506-4505
Practice Address - Country:US
Practice Address - Phone:505-257-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty