| Center For Psychotherapeutic Change | |
|
532 Don Gaspar Ave Santa Fe NM 87505-2626 | |
| (505) 986-3478 | |
| Not Available |
| Full Name | Center For Psychotherapeutic Change |
|---|---|
| Speciality | Counselor - Professional |
| Location | 532 Don Gaspar Ave, Santa Fe, New Mexico |
| Authorized Official Name and Position | Marcelle Grant (VICE PRESIDENT) |
| Authorized Official Contact | 5059863478 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Psychotherapeutic Change 1107 Caminito Alegre Santa Fe NM 87501-1605 Ph: (505) 986-3478 | Center For Psychotherapeutic Change 532 Don Gaspar Ave Santa Fe NM 87505-2626 Ph: (505) 986-3478 |
| NPI Number | 1871674887 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871674887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | I1319 (New Mexico) | Primary |
| 101YP2500X | Counselor - Professional | I1310 (New Mexico) | Secondary |
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