Provider Demographics
NPI:1659063600
Name:SMART PERSPECTIVES LLC
Entity Type:Organization
Organization Name:SMART PERSPECTIVES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO (CHIEF COUNSELING OFFICER)
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:575-495-4526
Mailing Address - Street 1:3122 SUMMER AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4062
Mailing Address - Country:US
Mailing Address - Phone:575-404-1593
Mailing Address - Fax:
Practice Address - Street 1:1909 CUBA AVE STE 1
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5646
Practice Address - Country:US
Practice Address - Phone:575-404-1593
Practice Address - Fax:575-404-1593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM06258204Medicaid