Provider Demographics
NPI:1346005642
Name:BILLIE, MARCUS (MA INTERN)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:BILLIE
Suffix:
Gender:M
Credentials:MA INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 BATAAN DR SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-2473
Mailing Address - Country:US
Mailing Address - Phone:505-409-3393
Mailing Address - Fax:
Practice Address - Street 1:1207 GOLF COURSE RD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87124-1999
Practice Address - Country:US
Practice Address - Phone:505-994-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health