STACY L BURLESON (NPI# 1033729652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033729652 |
| Entity Type | Individual |
| Full Name | STACY L BURLESON |
| Credential | CPSW |
| Practice Address |
3150 Carlisle Blvd Ne Ste 110 Albuquerque NM 87110-1681 |
| Mailing Address |
Po Box 45681 Rio Rancho NM 87174-5681 |
| Practice Telephone | 5056338173 |
| Practice Fax Number | 5052145071 |
| Mailing Telephone | 5052261960 |
| Mailing Fax Number | 5056727769 |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-08-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | S3-003 | NM | Other Service Providers |
| Street Address |
3150 CARLISLE BLVD NE STE 110 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-1681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063989648 | Umoja Behavioral Health PC | Nurse Practitioner | 3150 Carlisle Blvd Ne Ste 110, Albuquerque, NM 87110-1681 | 2018-11-01 |
| 1417555103 | Deona Jo Foust | Social Worker | 3150 Carlisle Blvd Ne Ste 110, Albuquerque, NM 87110-1681 | 2020-10-14 |
| 1861025215 | Sheila Scredon Montoya | Counselor | 3150 Carlisle Blvd Ne Ste 110, Albuquerque, NM 87110-1681 | 2020-02-13 |
| 1194365866 | Yzetta Elaine Martinez | Counselor | 3150 Carlisle Blvd Ne Ste 110, Albuquerque, NM 87110-1681 | 2020-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053882795 | Mateo R Duran | Peer Specialist | 10519 Trieste Ct Nw, Albuquerque, NM 87114-5187 | 2018-12-06 |
| 1891174140 | Osman Varela | Peer Specialist | 402 1/2 Harvard Dr Se, Albuquerque, NM 87106-3527 | 2015-05-20 |
| 1407456742 | Gabriela Gallegos | Peer Specialist | 912 1st St Nw, Albuquerque, NM 87102-2355 | 2020-10-27 |
| 1306443148 | Andrea Michelle Vallejos | Peer Specialist | 805 Tijeras Ave Nw, Albuquerque, NM 87102-3099 | 2020-10-05 |
| 1134738651 | Antonio N Johnson | Peer Specialist | 3301 Los Arboles Ave Ne, Albuquerque, NM 87107-1943 | 2020-07-30 |
| 1396363677 | Liliana Spurgeon | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-07-13 |
| 1801413026 | Christopher Padilla | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-07-03 |
| 1679196489 | Denise Lerouge | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-05-27 |
| 1942823125 | Dawn Green | Peer Specialist | 912 1st St Nw, Albuquerque, NM 87102-2355 | 2020-05-22 |
| 1346869054 | Brandi Encinias | Peer Specialist | 3301 Los Arboles Ave Ne, Albuquerque, NM 87107-1943 | 2020-04-13 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on STACY L BURLESON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.