| Gd Psych Services, Llc | |
|
2200 Grande Blvd Se Ste B Rio Rancho NM 87124-1695 | |
| (505) 218-6383 | |
| (774) 221-9193 |
| Full Name | Gd Psych Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2200 Grande Blvd Se Ste B, Rio Rancho, New Mexico |
| Authorized Official Name and Position | Stacey L Goldstein-dwyer (OWNER) |
| Authorized Official Contact | 5052186383 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gd Psych Services, Llc 2200 Grande Blvd Se Ste B Rio Rancho NM 87124-1695 Ph: (505) 218-6383 | Gd Psych Services, Llc 2200 Grande Blvd Se Ste B Rio Rancho NM 87124-1695 Ph: (505) 218-6383 |
| NPI Number | 1801379433 |
|---|---|
| Provider Enumeration Date | 09/10/2018 |
| Last Update Date | 06/25/2021 |
| Certification Date | 06/25/2021 |
| Medicare PECOS PAC ID | 6204260474 |
|---|---|
| Medicare Enrollment ID | O20191220001167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801379433 | NPI | - | NPPES |
| 98336843 | Medicaid | NM |
| Provider Name | Susanne S Drury |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346363207 PECOS PAC ID: 0042567182 Enrollment ID: I20180720001840 |
| Provider Name | Connie C Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831231885 PECOS PAC ID: 0941530224 Enrollment ID: I20190930002012 |
| Provider Name | Phillip Plemons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871840199 PECOS PAC ID: 8921321043 Enrollment ID: I20200219000297 |
| Provider Name | Christopher R O'donnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659902138 PECOS PAC ID: 6305267188 Enrollment ID: I20200603001033 |
| Provider Name | Jessica Marie Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093839375 PECOS PAC ID: 4284030834 Enrollment ID: I20210907001268 |
| Provider Name | Jacqueline Michelle Clifford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487125761 PECOS PAC ID: 3274983457 Enrollment ID: I20231229002714 |
| Provider Name | Melissa J Harris |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598332223 PECOS PAC ID: 5890134142 Enrollment ID: I20240418003385 |
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