| Support Is Apparent, Llc | |
|
9 Gaudian Loop Sandia Park NM 87047-9555 | |
| (505) 620-2119 | |
| (505) 445-4504 |
| Full Name | Support Is Apparent, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 9 Gaudian Loop, Sandia Park, New Mexico |
| Authorized Official Name and Position | Adrianna Gallegos (OWNER/PROVIDER) |
| Authorized Official Contact | 5052261800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Support Is Apparent, Llc 11600 Haines Ave Ne Albuquerque NM 87112-4452 Ph: (505) 620-2119 | Support Is Apparent, Llc 9 Gaudian Loop Sandia Park NM 87047-9555 Ph: (505) 620-2119 |
| NPI Number | 1053820902 |
|---|---|
| Provider Enumeration Date | 09/22/2017 |
| Last Update Date | 01/17/2022 |
| Certification Date | 01/17/2022 |
| Medicare PECOS PAC ID | 7719249655 |
|---|---|
| Medicare Enrollment ID | O20180313000957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053820902 | NPI | - | NPPES |
| 75700221 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Adrianna Christine Gallegos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427342864 PECOS PAC ID: 8628330560 Enrollment ID: I20180313001012 |
| Provider Name | Jeffrey Koenigsberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518204395 PECOS PAC ID: 7214305192 Enrollment ID: I20221128000303 |
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