| Sandia Therapy And Wellness Center | |
|
11005 Spain Rd Ne Ste 15 Albuquerque NM 87111-1871 | |
| (217) 419-0807 | |
| Not Available |
| Full Name | Sandia Therapy And Wellness Center |
|---|---|
| Speciality | Social Worker |
| Location | 11005 Spain Rd Ne Ste 15, Albuquerque, New Mexico |
| Authorized Official Name and Position | Chloe Edgar (CEO) |
| Authorized Official Contact | 2174190807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandia Therapy And Wellness Center Po Box 67216 Albuquerque NM 87193-7216 Ph: (217) 419-0807 | Sandia Therapy And Wellness Center 11005 Spain Rd Ne Ste 15 Albuquerque NM 87111-1871 Ph: (217) 419-0807 |
| NPI Number | 1588320576 |
|---|---|
| Provider Enumeration Date | 11/13/2021 |
| Last Update Date | 11/13/2021 |
| Certification Date | 11/13/2021 |
| Medicare PECOS PAC ID | 9335599612 |
|---|---|
| Medicare Enrollment ID | O20231228002853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588320576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Chloe Denise Edgar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871731315 PECOS PAC ID: 7012250731 Enrollment ID: I20190521003044 |
| Provider Name | Jennifer L Bear |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205317047 PECOS PAC ID: 7416307798 Enrollment ID: I20240305001811 |
| Provider Name | Mark Anthony Silla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851419121 PECOS PAC ID: 4284070558 Enrollment ID: I20240308001202 |
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