| Albuquerque Collaborative Therapeutics, Inc. | |
|
301 Graceland Dr Se Suite E Albuquerque NM 87108-2778 | |
| (505) 255-1756 | |
| (505) 255-1293 |
| Full Name | Albuquerque Collaborative Therapeutics, Inc. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 301 Graceland Dr Se, Albuquerque, New Mexico |
| Authorized Official Name and Position | Beth O'rourke (OWNER) |
| Authorized Official Contact | 5052551756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Albuquerque Collaborative Therapeutics, Inc. 301 Graceland Dr Se Suite E Albuquerque NM 87108-2778 Ph: (505) 255-1756 | Albuquerque Collaborative Therapeutics, Inc. 301 Graceland Dr Se Suite E Albuquerque NM 87108-2778 Ph: (505) 255-1756 |
| NPI Number | 1306961131 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8527320423 |
|---|---|
| Medicare Enrollment ID | O20180312001892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306961131 | NPI | - | NPPES |
| D4179 | Medicaid | NM |
| Provider Name | Kneelynn A Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932245255 PECOS PAC ID: 6608820410 Enrollment ID: I20050430000083 |
| Provider Name | Lydia J Fabbroni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699820035 PECOS PAC ID: 6709964042 Enrollment ID: I20080428000026 |
| Provider Name | Beth O'rourke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396802443 PECOS PAC ID: 1052673753 Enrollment ID: I20180405000094 |
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