Provider Demographics
NPI:1962790394
Name:TREIBEL, LYNNE MARIE (LISW)
Entity type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:MARIE
Last Name:TREIBEL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5345 WYOMING BLVD NE
Mailing Address - Street 2:SUITE 200F
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3148
Mailing Address - Country:US
Mailing Address - Phone:505-610-3966
Mailing Address - Fax:
Practice Address - Street 1:5345 WYOMING BLVD NE
Practice Address - Street 2:SUITE 200F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3148
Practice Address - Country:US
Practice Address - Phone:505-610-3966
Practice Address - Fax:505-610-3966
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-078461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical