Provider Demographics
NPI:1932507365
Name:REFLECTIONS PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:REFLECTIONS PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:505-379-2709
Mailing Address - Street 1:25 FISCHER LN
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059-8203
Mailing Address - Country:US
Mailing Address - Phone:505-379-2709
Mailing Address - Fax:
Practice Address - Street 1:3939 SAN PEDRO DR NE BLDG C8
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-8901
Practice Address - Country:US
Practice Address - Phone:505-379-2709
Practice Address - Fax:505-508-2686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty