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3250 Trinity Dr Ste C Los Alamos NM 87544-2226 | |
| (505) 412-0010 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 3250 Trinity Dr Ste C, Los Alamos, New Mexico |
| Authorized Official Name and Position | Thomas S. Steward (OWNER) |
| Authorized Official Contact | 5054120010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
62 Grand Canyon Dr White Rock NM 87547-3400 Ph: (505) 412-0010 | 3250 Trinity Dr Ste C Los Alamos NM 87544-2226 Ph: (505) 412-0010 |
| NPI Number | 1255605713 |
|---|---|
| Provider Enumeration Date | 03/01/2012 |
| Last Update Date | 12/20/2024 |
| Certification Date | 12/20/2024 |
| Medicare PECOS PAC ID | 1456502806 |
|---|---|
| Medicare Enrollment ID | O20121112000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255605713 | NPI | - | NPPES |
| 36083836 | Medicaid | NM | |
| 33470707 | Medicaid | NM |
| Provider Name | Tom S. Steward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285784553 PECOS PAC ID: 1456502814 Enrollment ID: I20121112000263 |
| Provider Name | Andrea K. Hill |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1831385418 PECOS PAC ID: 0042461402 Enrollment ID: I20240328000572 |
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