Provider Demographics
NPI:1417189945
Name:COUNSELING & PSYCHOTHERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:COUNSELING & PSYCHOTHERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFA, ATR, MSW
Authorized Official - Phone:505-948-6602
Mailing Address - Street 1:2127 RIO GRANDE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-2565
Mailing Address - Country:US
Mailing Address - Phone:505-948-6602
Mailing Address - Fax:505-842-1503
Practice Address - Street 1:2418 MILES RD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-3224
Practice Address - Country:US
Practice Address - Phone:505-948-6602
Practice Address - Fax:505-842-1503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2595101YM0800X
NMI047831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty