| Revive Therapy Center Llc | |
|
7013 4th St Nw Ste C Los Ranchos NM 87107-6639 | |
| (505) 356-2200 | |
| (844) 272-7030 |
| Full Name | Revive Therapy Center Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 7013 4th St Nw Ste C, Los Ranchos, New Mexico |
| Authorized Official Name and Position | Sally Von Erffa (MARRIAGE AND FAMILY THERAPIST) |
| Authorized Official Contact | 5052526797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Therapy Center Llc 376 Los Ranchos Rd Nw Los Ranchos NM 87107-6532 Ph: (505) 252-6797 | Revive Therapy Center Llc 7013 4th St Nw Ste C Los Ranchos NM 87107-6639 Ph: (505) 356-2200 |
| NPI Number | 1457822462 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/17/2018 |
| Medicare PECOS PAC ID | 0244671865 |
|---|---|
| Medicare Enrollment ID | O20240514003123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457822462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Sally B Von Erffa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265674154 PECOS PAC ID: 3971944596 Enrollment ID: I20240514003447 |
Gabriela Miller Lmft, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6501 4th St Nw Ste E-2, Los Ranchos, NM 87107 Phone: 505-803-1923 | |
Livingwell Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 312 Wayne Rd Nw, Los Ranchos, NM 87114 Phone: 505-792-4519 | |
Lotus Flower Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6666 4th St Nw Ste C-1, Los Ranchos, NM 87107 Phone: 505-463-0472 Fax: 505-312-7646 | |
Wild Magnolia Wellness Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6501 4th St Nw Ste H-5, Los Ranchos, NM 87107 Phone: 505-274-0112 | |
Sacred Souls Home Health Care Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8115 Rio Grande Blvd Nw, Los Ranchos, NM 87114 Phone: 505-730-0356 | |
Dianne Barnes Lpcc Lpat Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7013 4th St Nw Ste B, Los Ranchos, NM 87107 Phone: 505-492-5128 | |
Equanimity Group Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6666 4th St Nw, Los Ranchos, NM 87107 Phone: 505-226-5911 Fax: 505-581-3303 |