Provider Demographics
NPI:1457472649
Name:ELIZABETH C. STIRLING LLC
Entity Type:Organization
Organization Name:ELIZABETH C. STIRLING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:STIRLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-983-1583
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87504-1267
Mailing Address - Country:US
Mailing Address - Phone:505-983-1583
Mailing Address - Fax:505-989-1748
Practice Address - Street 1:1063 GOVERNOR DEMPSEY DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-1045
Practice Address - Country:US
Practice Address - Phone:505-983-1583
Practice Address - Fax:505-989-1748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM594103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMS9082Medicaid