Provider Demographics
NPI:1487613881
Name:ATKINSON, NORA KATHLEEN (MA, LPCC, LMSWLMFT)
Entity type:Individual
Prefix:MRS
First Name:NORA
Middle Name:KATHLEEN
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:MA, LPCC, LMSWLMFT
Other - Prefix:MRS
Other - First Name:KATHLEEN (KASS)
Other - Middle Name:C
Other - Last Name:ATKINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPCC, LMSWLMFT
Mailing Address - Street 1:2829 CALLE PRINCESA JUANA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-5317
Mailing Address - Country:US
Mailing Address - Phone:505-473-1643
Mailing Address - Fax:
Practice Address - Street 1:2829 CALLE PRINCESA JUANA
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-5317
Practice Address - Country:US
Practice Address - Phone:505-473-1643
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1281101Y00000X
NMM-2061104100000X
NM1779106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM06856713Medicaid