| A Shared Path Llc | |
|
4011 Barbara Loop Se Suite 107 Rio Rancho NM 87124-1039 | |
| (505) 730-6735 | |
| Not Available |
| Full Name | A Shared Path Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4011 Barbara Loop Se, Rio Rancho, New Mexico |
| Authorized Official Name and Position | Sherru Lebeznick Brown (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5057306735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Shared Path Llc 4608 Sam Bratton Ave Nw Albuquerque NM 87114-5333 Ph: (505) 730-6735 | A Shared Path Llc 4011 Barbara Loop Se Suite 107 Rio Rancho NM 87124-1039 Ph: (505) 730-6735 |
| NPI Number | 1689111841 |
|---|---|
| Provider Enumeration Date | 01/26/2017 |
| Last Update Date | 01/26/2017 |
| Medicare PECOS PAC ID | 4587005491 |
|---|---|
| Medicare Enrollment ID | O20240509001996 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689111841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C-07730 (New Mexico) | Primary |
| Provider Name | Sherry Lebeznick Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154504777 PECOS PAC ID: 3678878774 Enrollment ID: I20160229000371 |
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