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2601 Wyoming Blvd Ne Suite 208 Albuquerque NM 87112-1035 | |
| (505) 503-0272 | |
| (505) 503-1859 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2601 Wyoming Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Anne Gladden Snyder (DIRECTOR) |
| Authorized Official Contact | 5055030272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2601 Wyoming Blvd Ne Ste 208 Albuquerque NM 87112-1033 Ph: (505) 503-0272 | 2601 Wyoming Blvd Ne Suite 208 Albuquerque NM 87112-1035 Ph: (505) 503-0272 |
| NPI Number | 1134442270 |
|---|---|
| Provider Enumeration Date | 03/03/2010 |
| Last Update Date | 04/29/2024 |
| Certification Date | 04/29/2024 |
| Medicare PECOS PAC ID | 7618140633 |
|---|---|
| Medicare Enrollment ID | O20111107000636 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134442270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | FA0092024 (New Mexico) | Primary |
| Provider Name | Anne G Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023164498 PECOS PAC ID: 0840463865 Enrollment ID: I20111107000695 |
| Provider Name | Alix Rivard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548990054 PECOS PAC ID: 0042692691 Enrollment ID: I20220729001131 |
| Provider Name | Lisa Delmonico |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780143669 PECOS PAC ID: 1052756111 Enrollment ID: I20240228001977 |
| Provider Name | Tess A Gaudet |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083954937 PECOS PAC ID: 5890231484 Enrollment ID: I20240718004057 |
| Provider Name | Marisol Aldana |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023574811 PECOS PAC ID: 8921534967 Enrollment ID: I20241213000452 |
Integrated Healthcare Of New Mexico Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7632 William Moyers Ave Ne, Albuquerque, NM 87122 Phone: 505-554-1716 Fax: 505-792-5222 | |
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