| Sage Neuroscience Center Inc | |
|
7850 Jefferson St Ne Ste 300 Albuquerque NM 87109-4314 | |
| (505) 884-1114 | |
| (505) 359-3010 |
| Full Name | Sage Neuroscience Center Inc |
|---|---|
| Speciality | Counselor |
| Location | 7850 Jefferson St Ne Ste 300, Albuquerque, New Mexico |
| Authorized Official Name and Position | Reuben Sutter (OWNER) |
| Authorized Official Contact | 5058841114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Neuroscience Center Inc 7850 Jefferson St Ne Ste 300 Albuquerque NM 87109-4314 Ph: (505) 884-1114 | Sage Neuroscience Center Inc 7850 Jefferson St Ne Ste 300 Albuquerque NM 87109-4314 Ph: (505) 884-1114 |
| NPI Number | 1578644415 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 11/15/2022 |
| Certification Date | 11/15/2022 |
| Medicare PECOS PAC ID | 5395840383 |
|---|---|
| Medicare Enrollment ID | O20070419000586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578644415 | NPI | - | NPPES |
| 1962463877 | Other | NM | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MD2005-0751 (New Mexico) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Laura R Stern |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336157460 PECOS PAC ID: 1456253590 Enrollment ID: I20040121000305 |
| Provider Name | Richard B Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225107824 PECOS PAC ID: 7517851025 Enrollment ID: I20040213000200 |
| Provider Name | Patricia L Bryant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114961786 PECOS PAC ID: 3577558469 Enrollment ID: I20040419001590 |
| Provider Name | Leah A Rudnick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972518439 PECOS PAC ID: 2567413784 Enrollment ID: I20050204000602 |
| Provider Name | Reuben L Sutter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962463877 PECOS PAC ID: 3274555719 Enrollment ID: I20070419000627 |
| Provider Name | Emily C Deaton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255466967 PECOS PAC ID: 2668579301 Enrollment ID: I20070515000216 |
| Provider Name | Kathleen M Colleran |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659386118 PECOS PAC ID: 4587746714 Enrollment ID: I20080128000326 |
| Provider Name | Brenda L Wolfe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063411973 PECOS PAC ID: 5496823692 Enrollment ID: I20081001000092 |
| Provider Name | Bryan Krumm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457547796 PECOS PAC ID: 0244386050 Enrollment ID: I20090921000308 |
| Provider Name | Anne G Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023164498 PECOS PAC ID: 0840463865 Enrollment ID: I20111107000695 |
| Provider Name | Eva S Velasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891055745 PECOS PAC ID: 3375798671 Enrollment ID: I20130312000118 |
| Provider Name | Anthony James Holzgang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073598298 PECOS PAC ID: 6103014774 Enrollment ID: I20131008000283 |
| Provider Name | Stephanie Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144535915 PECOS PAC ID: 9436471349 Enrollment ID: I20141204000405 |
| Provider Name | Tamara Abousleman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861520330 PECOS PAC ID: 4183946007 Enrollment ID: I20141204000758 |
| Provider Name | Marita L Campos-melady |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700286457 PECOS PAC ID: 2264755115 Enrollment ID: I20141229000579 |
| Provider Name | Melissa A Merhege |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1003111873 PECOS PAC ID: 0244547636 Enrollment ID: I20170105000078 |
| Provider Name | Patricia A Pade |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1174726582 PECOS PAC ID: 5092954289 Enrollment ID: I20170320001110 |
| Provider Name | Jana Weisborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487975082 PECOS PAC ID: 7618246489 Enrollment ID: I20170711000768 |
| Provider Name | Nancy Roope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316151368 PECOS PAC ID: 8426313230 Enrollment ID: I20180529001336 |
| Provider Name | Matthew K Greenwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033680566 PECOS PAC ID: 2860733177 Enrollment ID: I20190416000113 |
| Provider Name | Julia Gallant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619037454 PECOS PAC ID: 7012906498 Enrollment ID: I20200429002412 |
| Provider Name | Tracy F Fabre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558860908 PECOS PAC ID: 5092137885 Enrollment ID: I20200624002015 |
| Provider Name | Mary K Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013513779 PECOS PAC ID: 4789091695 Enrollment ID: I20210319002218 |
| Provider Name | Jack P Hancock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093321689 PECOS PAC ID: 7911314042 Enrollment ID: I20210407001733 |
| Provider Name | Joshua D Everett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790355477 PECOS PAC ID: 7113320912 Enrollment ID: I20210729003996 |
| Provider Name | Elena Crespin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124781539 PECOS PAC ID: 6709275332 Enrollment ID: I20211119000588 |
| Provider Name | Alix Rivard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548990054 PECOS PAC ID: 0042692691 Enrollment ID: I20220729001131 |
| Provider Name | Petra D Lamla Laban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104539428 PECOS PAC ID: 6800268194 Enrollment ID: I20230215000566 |
| Provider Name | Rhiannon L Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639485808 PECOS PAC ID: 8628425014 Enrollment ID: I20231107000543 |
| Provider Name | Luz E Browning |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801387964 PECOS PAC ID: 7113379074 Enrollment ID: I20240117001178 |
| Provider Name | Yvonne R Moghadam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740610955 PECOS PAC ID: 1355793761 Enrollment ID: I20240122003718 |
| Provider Name | Rufus Greene |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912616673 PECOS PAC ID: 0345521282 Enrollment ID: I20240129002651 |
| Provider Name | Crystal Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336304278 PECOS PAC ID: 2961855671 Enrollment ID: I20240130000972 |
| Provider Name | Marisa M Rothrock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174024988 PECOS PAC ID: 7719330430 Enrollment ID: I20240130001533 |
| Provider Name | Micah M Macdonald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508099904 PECOS PAC ID: 4688017890 Enrollment ID: I20240205002673 |
| Provider Name | Brenda L Frink |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689773699 PECOS PAC ID: 0446693527 Enrollment ID: I20240206000550 |
| Provider Name | Sarah M Skoterro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013122811 PECOS PAC ID: 7214371384 Enrollment ID: I20240216000462 |
| Provider Name | Jennifer J Clysdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386405678 PECOS PAC ID: 9335583244 Enrollment ID: I20240220000759 |
| Provider Name | Jeanine M Forsythe Cordoba |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801239660 PECOS PAC ID: 6002256070 Enrollment ID: I20240425000231 |
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: 3908 Carlisle Blvd Ne, Albuquerque, NM 87107 Phone: 505-903-0927 |