Cross Roots Counseling Llc | |
121 Wellesley Dr Se Albuquerque NM 87106-1443 | |
(505) 273-2030 | |
Not Available |
Full Name | Cross Roots Counseling Llc |
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Speciality | Psychologist |
Location | 121 Wellesley Dr Se, Albuquerque, New Mexico |
Authorized Official Name and Position | Vanessa Lopez Viets (OWNER) |
Authorized Official Contact | 5052732030 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cross Roots Counseling Llc 12231 Academy Rd Ne Suite 301 Pmb 295 Albuquerque NM 87111 Ph: () - | Cross Roots Counseling Llc 121 Wellesley Dr Se Albuquerque NM 87106-1443 Ph: (505) 273-2030 |
NPI Number | 1063150290 |
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Provider Enumeration Date | 05/26/2022 |
Last Update Date | 05/26/2022 |
Certification Date | 05/26/2022 |
Medicare PECOS PAC ID | 8325480577 |
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Medicare Enrollment ID | O20240521000062 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063150290 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Vanessa C Lopez-viets |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1205161882 PECOS PAC ID: 8628116597 Enrollment ID: I20091113000121 |
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