| Grace Therapy Services, Llc | |
|
4273 Montgomery Blvd Ne Ste K220 Albuquerque NM 87109-6748 | |
| (505) 554-1283 | |
| Not Available |
| Full Name | Grace Therapy Services, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4273 Montgomery Blvd Ne Ste K220, Albuquerque, New Mexico |
| Authorized Official Name and Position | Ashley Noelle Martin-cuellar (OWNER) |
| Authorized Official Contact | 5755717499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Therapy Services, Llc 4273 Montgomery Blvd Ne Ste K220 Albuquerque NM 87109-6748 Ph: (505) 554-1283 | Grace Therapy Services, Llc 4273 Montgomery Blvd Ne Ste K220 Albuquerque NM 87109-6748 Ph: (505) 554-1283 |
| NPI Number | 1821561911 |
|---|---|
| Provider Enumeration Date | 01/10/2019 |
| Last Update Date | 09/27/2024 |
| Certification Date | 09/27/2024 |
| Medicare PECOS PAC ID | 8820441371 |
|---|---|
| Medicare Enrollment ID | O20240131002713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821561911 | NPI | - | NPPES |
| 1366766339 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Ashley Mft Martin-cuellar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1366766339 PECOS PAC ID: 2466805916 Enrollment ID: I20240131003161 |
| Provider Name | Joyce L Mackinstry |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1710125174 PECOS PAC ID: 3173968963 Enrollment ID: I20240304000326 |
| Provider Name | Hailey Chavez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1396348306 PECOS PAC ID: 7517302227 Enrollment ID: I20240304001124 |
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