| Life Change Psychotherapy Institute, Pc | |
|
1200 Eubank Blvd Ne Albuquerque NM 87112-5314 | |
| (505) 271-5050 | |
| (505) 271-1080 |
| Full Name | Life Change Psychotherapy Institute, Pc |
|---|---|
| Speciality | Counselor |
| Location | 1200 Eubank Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Thomas F. Mckenna (PRESIDENT) |
| Authorized Official Contact | 5052715050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Change Psychotherapy Institute, Pc 1200 Eubank Blvd Ne Albuquerque NM 87112-5314 Ph: (505) 271-5050 | Life Change Psychotherapy Institute, Pc 1200 Eubank Blvd Ne Albuquerque NM 87112-5314 Ph: (505) 271-5050 |
| NPI Number | 1740409135 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6305107897 |
|---|---|
| Medicare Enrollment ID | O20180226000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740409135 | NPI | - | NPPES |
| 1194897108 | Other | NM | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0892 (New Mexico) | Primary |
| Provider Name | Gary L Harmon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730117649 PECOS PAC ID: 2264595792 Enrollment ID: I20090428000361 |
| Provider Name | Patricia E Mckenna |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467525345 PECOS PAC ID: 2466713961 Enrollment ID: I20180226002624 |
| Provider Name | Christopher D Blazina |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275569774 PECOS PAC ID: 0143233858 Enrollment ID: I20180227003180 |
| Provider Name | Steve C Liu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861063687 PECOS PAC ID: 7214314186 Enrollment ID: I20220513002427 |
| Provider Name | Rachel A Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487061610 PECOS PAC ID: 2264813963 Enrollment ID: I20220712003651 |
| Provider Name | Sarah Lynn Lee |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558350918 PECOS PAC ID: 8921459629 Enrollment ID: I20240107000063 |
| Provider Name | Kristin Knoll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720076136 PECOS PAC ID: 9032560586 Enrollment ID: I20240109001843 |
| Provider Name | Rachel Millsop |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598154106 PECOS PAC ID: 1052763471 Enrollment ID: I20240122000359 |
| Provider Name | Karen Sue Stockham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194387449 PECOS PAC ID: 4587016936 Enrollment ID: I20240122001570 |
| Provider Name | Alison Elizabeth Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942428693 PECOS PAC ID: 9032562228 Enrollment ID: I20240124000848 |
| Provider Name | Anne Lawrence |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1699809228 PECOS PAC ID: 3678926029 Enrollment ID: I20240201001582 |
Integrated Healthcare Of New Mexico Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7632 William Moyers Ave Ne, Albuquerque, NM 87122 Phone: 505-554-1716 Fax: 505-792-5222 | |
Lotus Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2626 Central Ave Sw, Albuquerque, NM 87104 Phone: 505-238-9551 | |
Choices Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3620 Wyoming Blvd Ne, Suite L3, Albuquerque, NM 87111 Phone: 505-730-6791 Fax: 505-814-5740 | |
Broken Arrow Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 840 Simon Ln Sw, Albuquerque, NM 87105 Phone: 505-818-7934 | |
Mind Over Matters Holistic Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2424 Palomas Dr Ne, Albuquerque, NM 87110 Phone: 505-459-6980 | |
Solamente Holistic Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 833 Lomas Blvd Nw, Albuquerque, NM 87102 Phone: 505-243-6353 | |
Meridian Behavioral Health Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3539 Thaxton Ave Se, Albuquerque, NM 87106 Phone: 505-903-0927 |