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2901 Juan Tabo Blvd Ne Ste 101a Albuquerque NM 87112-1886 | |
| (505) 280-1928 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2901 Juan Tabo Blvd Ne Ste 101a, Albuquerque, New Mexico |
| Authorized Official Name and Position | James Barner (CEO) |
| Authorized Official Contact | 5052801928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2901 Juan Tabo Blvd Ne Ste 101a Albuquerque NM 87112-1886 Ph: (505) 280-1928 | 2901 Juan Tabo Blvd Ne Ste 101a Albuquerque NM 87112-1886 Ph: (505) 280-1928 |
| NPI Number | 1821634171 |
|---|---|
| Provider Enumeration Date | 11/21/2019 |
| Last Update Date | 12/18/2019 |
| Certification Date | 12/18/2019 |
| Medicare PECOS PAC ID | 3274906896 |
|---|---|
| Medicare Enrollment ID | O20240903000825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821634171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Donna Saylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639834112 PECOS PAC ID: 6709325632 Enrollment ID: I20240823000836 |
| Provider Name | Krystalyn Madden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740813773 PECOS PAC ID: 4880133719 Enrollment ID: I20240823000866 |
| Provider Name | Robert Lewis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1417104183 PECOS PAC ID: 2264971100 Enrollment ID: I20240823001176 |
| Provider Name | Xochitl Valenzuela |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508457284 PECOS PAC ID: 9436698305 Enrollment ID: I20240823002035 |
| Provider Name | Denise Barner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497225387 PECOS PAC ID: 8820461445 Enrollment ID: I20240903002213 |
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