Provider Demographics
NPI:1356899785
Name:CHRISTINE WADE-BECHER THERAPY, LLC
Entity type:Organization
Organization Name:CHRISTINE WADE-BECHER THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ALETHEA
Authorized Official - Last Name:WADE-BECHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-220-3643
Mailing Address - Street 1:PO BOX 14837
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87191-4837
Mailing Address - Country:US
Mailing Address - Phone:505-220-3643
Mailing Address - Fax:
Practice Address - Street 1:231 SIERRA DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5632
Practice Address - Country:US
Practice Address - Phone:505-220-3463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-079711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1447583935OtherINDIVIDUAL NPI NUMBER