| Fyi | |
|
1320 S. Solano Drive Las Cruces NM 88001-3758 | |
| (505) 522-4004 | |
| (505) 522-9017 |
| Full Name | Fyi |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1320 S. Solano Drive, Las Cruces, New Mexico |
| Authorized Official Name and Position | Brian Kavanaugh (CEO) |
| Authorized Official Contact | 5756440485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fyi Po Box 1868 Las Cruces NM 88004-1868 Ph: (505) 522-4004 | Fyi 1320 S. Solano Drive Las Cruces NM 88001-3758 Ph: (505) 522-4004 |
| NPI Number | 1003031436 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 04/12/2023 |
| Certification Date | 04/12/2023 |
| Medicare PECOS PAC ID | 9739546284 |
|---|---|
| Medicare Enrollment ID | O20230529000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003031436 | NPI | - | NPPES |
| B9814 | Medicaid | NM | |
| M1497 | Medicaid | NM | |
| M0161 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 1077A (New Mexico) | Secondary |
| Provider Name | Kathryn J. Schmidt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205390580 PECOS PAC ID: 3678981578 Enrollment ID: I20210414000416 |
| Provider Name | Serina Monique Apodaca-peckham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194189829 PECOS PAC ID: 0547620031 Enrollment ID: I20230714003672 |
| Provider Name | Lisa Noelani Chavez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013300854 PECOS PAC ID: 0446611339 Enrollment ID: I20230725000615 |
| Provider Name | Matthew David Cashion |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316165467 PECOS PAC ID: 9537520333 Enrollment ID: I20230726001700 |
| Provider Name | Tiffanie Hines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225434384 PECOS PAC ID: 0840651592 Enrollment ID: I20230728000402 |
| Provider Name | Lisandro Galvan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285368373 PECOS PAC ID: 8820445620 Enrollment ID: I20231116001535 |
| Provider Name | Carrigen Cain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588313605 PECOS PAC ID: 7113377045 Enrollment ID: I20231219000957 |
| Provider Name | Brianna Dever |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417438672 PECOS PAC ID: 9032569595 Enrollment ID: I20231223000065 |
| Provider Name | Julieta Campos-medina |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467614024 PECOS PAC ID: 4587025887 Enrollment ID: I20231227000143 |
| Provider Name | Alexis Nichole Villa |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1023635745 PECOS PAC ID: 1850741067 Enrollment ID: I20240102000187 |
| Provider Name | Justina Sanchez |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1164956595 PECOS PAC ID: 8426400375 Enrollment ID: I20240117000644 |
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