| Ocotillo Psychological Services Llc | |
|
2801 Missouri Ave Ste 36 Las Cruces NM 88011-9151 | |
| (575) 635-2002 | |
| Not Available |
| Full Name | Ocotillo Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2801 Missouri Ave Ste 36, Las Cruces, New Mexico |
| Authorized Official Name and Position | Tracie Hitter (ORGANIZER) |
| Authorized Official Contact | 5756352002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocotillo Psychological Services Llc 1830 Myrtle Ave Las Cruces NM 88001-5245 Ph: (575) 635-2002 | Ocotillo Psychological Services Llc 2801 Missouri Ave Ste 36 Las Cruces NM 88011-9151 Ph: (575) 635-2002 |
| NPI Number | 1629558838 |
|---|---|
| Provider Enumeration Date | 08/16/2018 |
| Last Update Date | 04/08/2020 |
| Certification Date | 04/08/2020 |
| Medicare PECOS PAC ID | 2466882485 |
|---|---|
| Medicare Enrollment ID | O20200415000920 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629558838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PSY1460 (New Mexico) | Primary |
| Provider Name | Tracie Hitter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629585534 PECOS PAC ID: 7719317734 Enrollment ID: I20200415001158 |
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