Mr Mark Anthony Silla, LPCC | |
6276 Terrell Dr, Tucumcari, NM 88401-9547 | |
(505) 708-0033 | |
Not Available |
Full Name | Mr Mark Anthony Silla |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 6276 Terrell Dr, Tucumcari, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851419121 | NPI | - | NPPES |
18851419121 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 010371 (New Mexico) | Primary |
Entity Name | Sandia Therapy And Wellness Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588320576 PECOS PAC ID: 9335599612 Enrollment ID: O20231228002853 |
Mailing Address | Practice Location Address |
---|---|
Mr Mark Anthony Silla, LPCC Po Box 833, Tucumcari, NM 88401-0833 Ph: (575) 708-0033 | Mr Mark Anthony Silla, LPCC 6276 Terrell Dr, Tucumcari, NM 88401-9547 Ph: (505) 708-0033 |
Krystal R Tapia, BMS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 575-461-4411 | |
Ethel Shaw, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E. High Street, Tucumcari, NM 88401 Phone: 575-461-4411 Fax: 575-461-4102 | |
Ann Largent, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 102 E High St, Tucumcari, NM 88401 Phone: 505-461-6200 Fax: 505-461-0404 | |
Robert Noel Poe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 575-461-4411 | |
Ashley Ann Nolan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 575-461-4411 | |
Jacqueline Garcia, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 575-461-4411 Fax: 575-461-4102 | |
Vicky Laredo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E High St, Tucumcari, NM 88401 Phone: 505-461-4411 |