Provider Demographics
NPI:1437527660
Name:CONTROL OVER ANXIETY, LLC
Entity Type:Organization
Organization Name:CONTROL OVER ANXIETY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAURITS
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-908-1450
Mailing Address - Street 1:3949 CORRALES RD STE 180
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-9349
Mailing Address - Country:US
Mailing Address - Phone:505-738-3621
Mailing Address - Fax:
Practice Address - Street 1:3949 CORRALES RD STE 180
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-9349
Practice Address - Country:US
Practice Address - Phone:505-738-3621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM88-2532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty