| North Star Psychotherapy Llc | |
|
208 Paseo Del Pueblo Sur Unit 103 Taos NM 87571-5931 | |
| (575) 770-7836 | |
| Not Available |
| Full Name | North Star Psychotherapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 208 Paseo Del Pueblo Sur Unit 103, Taos, New Mexico |
| Authorized Official Name and Position | Whitney Lake (REGISTERED AGENT) |
| Authorized Official Contact | 5757707836 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Star Psychotherapy Llc Po Box 164 Arroyo Seco NM 87514-0164 Ph: (575) 770-7836 | North Star Psychotherapy Llc 208 Paseo Del Pueblo Sur Unit 103 Taos NM 87571-5931 Ph: (575) 770-7836 |
| NPI Number | 1760173173 |
|---|---|
| Provider Enumeration Date | 05/17/2023 |
| Last Update Date | 05/17/2023 |
| Certification Date | 05/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760173173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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