| Child Counseling Center And Play Therapy Institute Of New Mexico | |
|
1400 Maclovia St Ste 1 Santa Fe NM 87505-3253 | |
| (505) 772-0459 | |
| Not Available |
| Full Name | Child Counseling Center And Play Therapy Institute Of New Mexico |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1400 Maclovia St Ste 1, Santa Fe, New Mexico |
| Authorized Official Name and Position | Susan Bienvenu (FOUNDER) |
| Authorized Official Contact | 5053161182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Counseling Center And Play Therapy Institute Of New Mexico 534 Juniper Dr Santa Fe NM 87501-1324 Ph: (505) 316-1182 | Child Counseling Center And Play Therapy Institute Of New Mexico 1400 Maclovia St Ste 1 Santa Fe NM 87505-3253 Ph: (505) 772-0459 |
| NPI Number | 1619536141 |
|---|---|
| Provider Enumeration Date | 06/09/2019 |
| Last Update Date | 12/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619536141 | NPI | - | NPPES |
| 32055072 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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