| Blue Sage Counseling And Psychotherapy, Llc | |
|
1839 Betts St Ne Albuquerque NM 87112-3103 | |
| (505) 463-1829 | |
| Not Available |
| Full Name | Blue Sage Counseling And Psychotherapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1839 Betts St Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Russell E. Adams (PRESIDENT) |
| Authorized Official Contact | 5054631829 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Sage Counseling And Psychotherapy, Llc 1839 Betts St Ne Albuquerque NM 87112-3103 Ph: (505) 463-1829 | Blue Sage Counseling And Psychotherapy, Llc 1839 Betts St Ne Albuquerque NM 87112-3103 Ph: (505) 463-1829 |
| NPI Number | 1578845962 |
|---|---|
| Provider Enumeration Date | 09/13/2011 |
| Last Update Date | 09/13/2011 |
| Medicare PECOS PAC ID | 8325203573 |
|---|---|
| Medicare Enrollment ID | O20120713000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578845962 | NPI | - | NPPES |
| 33827028 | Medicaid | NM | |
| 1396894994 | Other | NM | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I-05493 (New Mexico) | Primary |
| Provider Name | Russell E Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396894994 PECOS PAC ID: 2466502794 Enrollment ID: I20090609000179 |
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