| Senior Psychological Care Of New Mexico, Llc | |
|
1402 W Gilchrist Ave Artesia NM 88210-1134 | |
| (713) 850-0049 | |
| Not Available |
| Full Name | Senior Psychological Care Of New Mexico, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1402 W Gilchrist Ave, Artesia, New Mexico |
| Authorized Official Name and Position | Randall J Frapart (CFO) |
| Authorized Official Contact | 7138500049 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Psychological Care Of New Mexico, Llc 4635 Southwest Fwy Ste 635 Houston TX 77027-7112 Ph: (713) 850-0049 | Senior Psychological Care Of New Mexico, Llc 1402 W Gilchrist Ave Artesia NM 88210-1134 Ph: (713) 850-0049 |
| NPI Number | 1013617240 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 03/07/2023 |
| Certification Date | 03/07/2023 |
| Medicare PECOS PAC ID | 6305286642 |
|---|---|
| Medicare Enrollment ID | O20240502003615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013617240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Jasmine Gutierrez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104440221 PECOS PAC ID: 3375984404 Enrollment ID: I20240507003287 |
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