Provider Demographics
NPI:1629314844
Name:SYNERGY BEHAVIORAL HEALTH, P. C.
Entity Type:Organization
Organization Name:SYNERGY BEHAVIORAL HEALTH, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:SPARKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:575-725-5562
Mailing Address - Street 1:207 W MCKAY ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5835
Mailing Address - Country:US
Mailing Address - Phone:575-725-5562
Mailing Address - Fax:575-541-3495
Practice Address - Street 1:207 W MCKAY ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5835
Practice Address - Country:US
Practice Address - Phone:575-725-5562
Practice Address - Fax:575-541-3495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-15
Last Update Date:2012-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty