| High Desert Healing | |
|
4201 Carlisle Blvd Ne Albuquerque NM 87107-4808 | |
| (505) 717-1332 | |
| Not Available |
| Full Name | High Desert Healing |
|---|---|
| Speciality | Social Worker |
| Location | 4201 Carlisle Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Lauren Gomez (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5057171332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| High Desert Healing 4201 Carlisle Blvd Ne Albuquerque NM 87107-4808 Ph: (505) 717-1332 | High Desert Healing 4201 Carlisle Blvd Ne Albuquerque NM 87107-4808 Ph: (505) 717-1332 |
| NPI Number | 1265938203 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 11/05/2020 |
| Certification Date | 11/05/2020 |
| Medicare PECOS PAC ID | 2769711050 |
|---|---|
| Medicare Enrollment ID | O20190911003527 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265938203 | NPI | - | NPPES |
| 96284374 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | C-06315 (New Mexico) | Primary |
| Provider Name | Mark S Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518952662 PECOS PAC ID: 6709901044 Enrollment ID: I20100910000202 |
| Provider Name | Philip Tatoris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548382039 PECOS PAC ID: 1153684733 Enrollment ID: I20180412001352 |
| Provider Name | Sara Rhodes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689026577 PECOS PAC ID: 5597009845 Enrollment ID: I20181128000206 |
| Provider Name | Lauren Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619489564 PECOS PAC ID: 4284963570 Enrollment ID: I20200225000162 |
| Provider Name | Rebecca Kathleen Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063858702 PECOS PAC ID: 4183051592 Enrollment ID: I20200225001356 |
| Provider Name | Adam R Vareika |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093985392 PECOS PAC ID: 8224214440 Enrollment ID: I20200914002142 |
| Provider Name | Samantha C Parker Zillich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710402680 PECOS PAC ID: 9638567480 Enrollment ID: I20211027001063 |
| Provider Name | Leah Feazel Nelson |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1578926846 PECOS PAC ID: 0547554891 Enrollment ID: I20220607002573 |
| Provider Name | Mikaella Merrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477338341 PECOS PAC ID: 0840649844 Enrollment ID: I20231215003408 |
| Provider Name | Aubrey Jenna Stallings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750965109 PECOS PAC ID: 0840633855 Enrollment ID: I20240207000373 |
| Provider Name | Jessey Stallings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669056917 PECOS PAC ID: 6204271455 Enrollment ID: I20240228001301 |
| Provider Name | Faith Myranda Giron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700473378 PECOS PAC ID: 3678919529 Enrollment ID: I20240313003443 |
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