| Sierra Blanca Counseling | |
|
2904 Sudderth Dr Ruidoso NM 88345-6338 | |
| (575) 491-3300 | |
| (844) 876-6786 |
| Full Name | Sierra Blanca Counseling |
|---|---|
| Speciality | Counselor |
| Location | 2904 Sudderth Dr, Ruidoso, New Mexico |
| Authorized Official Name and Position | Emily J Fleming (OWNER/THERAPIST) |
| Authorized Official Contact | 5754913300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sierra Blanca Counseling 2904 Sudderth Dr Ruidoso NM 88345-6338 Ph: (575) 491-3300 | Sierra Blanca Counseling 2904 Sudderth Dr Ruidoso NM 88345-6338 Ph: (575) 491-3300 |
| NPI Number | 1770941486 |
|---|---|
| Provider Enumeration Date | 02/09/2016 |
| Last Update Date | 07/20/2020 |
| Certification Date | 07/20/2020 |
| Medicare PECOS PAC ID | 3577995760 |
|---|---|
| Medicare Enrollment ID | O20191108000742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770941486 | NPI | - | NPPES |
| 1235393182 | Other | NM | NPI |
| 1013288208 | Medicaid | NM | |
| 23700386 | Medicaid | NM | |
| 1720416795 | Other | NM | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6864 (New Mexico) | Primary |
| Provider Name | Emily J. Fleming |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013288208 PECOS PAC ID: 9739511932 Enrollment ID: I20240502000233 |
| Provider Name | Yasna C Quiveors |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003249871 PECOS PAC ID: 1658712419 Enrollment ID: I20240510000121 |
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Region Ix Education Cooperative Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 237 Service Rd, Ruidoso, NM 88345 Phone: 575-257-2368 | |
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Region Ix Education Cooperative Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Sudderth Dr, Ruidoso, NM 88345 Phone: 505-257-2368 Fax: 505-257-2141 | |
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