| Conscious Counseling, Llc | |
|
5 Val Verde Dr Santa Fe NM 87508-4619 | |
| (210) 313-1760 | |
| Not Available |
| Full Name | Conscious Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5 Val Verde Dr, Santa Fe, New Mexico |
| Authorized Official Name and Position | Jennifer Lynne Jackson (OWNER) |
| Authorized Official Contact | 2103131760 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conscious Counseling, Llc 5 Val Verde Dr Santa Fe NM 87508-4619 Ph: (210) 313-1760 | Conscious Counseling, Llc 5 Val Verde Dr Santa Fe NM 87508-4619 Ph: (210) 313-1760 |
| NPI Number | 1679258354 |
|---|---|
| Provider Enumeration Date | 06/20/2023 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Medicare PECOS PAC ID | 7113372137 |
|---|---|
| Medicare Enrollment ID | O20231011003141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679258354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jennifer Lynne Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124419270 PECOS PAC ID: 6507266657 Enrollment ID: I20210611001188 |
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