ELENA BETTOLIVAUGHAN (NPI# 1083730980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083730980 |
| Entity Type | Individual |
| Full Name | ELENA BETTOLIVAUGHAN |
| Credential | PHD |
| Practice Address |
1325 Wyoming Blvd Ne Pmg Kaseman Behavioral Medicine Albuquerque NM 87112-5046 |
| Mailing Address |
Po Box 26666 Phs Provider Enrollment Albuquerque NM 87125-6666 |
| Practice Telephone | 5052912536 |
| Practice Fax Number | 5052915327 |
| Mailing Telephone | 5059235356 |
| Mailing Fax Number | 5059235354 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2009-12-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
644 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 000K2674 | 05 |
| Street Address |
1325 WYOMING BLVD NE PMG KASEMAN BEHAVIORAL MEDICINE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87112-5046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700823572 | Leslie P Kurtz | Pediatrics | 1325 Wyoming Blvd Ne, Pmg Kaseman Behavioral Medicine, Albuquerque, NM 87112-5046 | 2006-06-01 |
| 1023484755 | Marissa Lynne Borrello | Psychologist | 1325 Wyoming Blvd Ne, Albuquerque, NM 87112-5046 | 2015-08-17 |
| 1205219623 | Jennifer Fawn Bernard | Psychologist | 1325 Wyoming Blvd Ne, Pmg Kaseman Behavioral Medicine, Albuquerque, NM 87112-5046 | 2015-07-02 |
| 1821424227 | Marsha Delaine Sapp | Nurse Practitioner | 1325 Wyoming Blvd Ne, Albuquerque, NM 87112-5046 | 2013-09-18 |
| 1063796605 | Cheri Marie Cerghizan | Nurse Practitioner | 1325 Wyoming Blvd Ne, Albuquerque, NM 87112-5046 | 2011-09-30 |
| 1073758850 | Monica Zmuda | Counselor | 1325 Wyoming Blvd Ne, Albuquerque, NM 87112-5046 | 2008-12-09 |
| 1003084195 | Christopher Manetta | Psychiatry & Neurology | 1325 Wyoming Blvd Ne, Pmg Kaseman Behavioral Medicine, Albuquerque, NM 87112-5046 | 2008-02-12 |
| 1417137977 | Stephanie Tucker | Psychiatry & Neurology | 1325 Wyoming Blvd Ne, Pmg Kaseman Behavioral Medicine, Albuquerque, NM 87112-5046 | 2007-11-13 |
| 1760671978 | Judith Wherritt Brooks | Counselor | 1325 Wyoming Blvd Ne, Albuquerque, NM 87112-5046 | 2007-10-24 |
| 1174726582 | Patricia A Pade | Internal Medicine | 1325 Wyoming Blvd Ne, Albuquerque, NM 87112-5046 | 2007-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356999411 | Lynn Eileen Riley | Counselor | 10205 Stovall Pl Ne, Albuquerque, NM 87112 | 2019-08-30 |
| 1548818222 | Cindy D Montoya | Technician | 11405 Snow Heights Blvd Ne, Albuquerque, NM 87112 | 2019-08-27 |
| 1194387449 | Karen Sue Stockham | Counselor | 9024 Aspen Ave Ne, Albuquerque, NM 87112 | 2019-07-07 |
| 1316416837 | New Beginning Counseling Services Inc | Counselor | 2617 Juan Tabo Blvd Ne Unit A/d, Albuquerque, NM 87112 | 2018-11-14 |
| 1306365929 | Calyx Institute LLC | Social Worker | 10701 Lomas Blvd Ne, Ste. 101, Albuquerque, NM 87112 | 2017-09-14 |
| 1811411135 | Annette Romero | Case Manager/Care Coordinator | 9741 Candelaria, Albuquerque, NM 87112 | 2017-07-28 |
| 1851814784 | Ally Renee Funkhouser Dye | Pediatrics | 2130 Eubank Blvd Ne, Albuquerque, NM 87112 | 2017-07-23 |
| 1508303140 | Makena Bailey Nash | Behavior Technician | 12801 Indian School Ne Apt 508, Albuquerque, NM 87112 | 2017-01-20 |
| 1477978906 | Albert R Toya | Massage Therapist | 2601 Wyoming Blvd N.e. Room 115-c, Albuquerque, NM 87112 | 2014-02-20 |
| 1184918104 | Jennifer E Chavez | Counselor | 1505 Marron Circle Ne, Albuquerque, NM 87112 | 2011-06-07 |
| Find all providers in zip 87112 | ||||
| Taxonomy Code | 103TP0814X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Psychoanalysis |
| (1) A practitioner of psychoanalysis: methods of eliciting from patients their past emotional experiences and their role in influencing their current mental life, in order to discover the conflicts and mechanisms by which their pathologic mental state has been produced and to furnish hints for psychotherapeutic procedures, the method employs free association, recall and interpretation of dreams and interpretation of transference and resistance phenomena; (2) An individual who is educated with a doctor’s degree in psychoanalysis or psychology, trained at an established psychoanalytic institute, and practices or adheres to the principles of psychoanalysis. Psychoanalysis is a form of psychotherapy and a system of investigation for determining and understanding mental processes, which was originally conceived by Sigmund Freud. Psychoanalysis involves the analysis and interpretation of dreams, resistances, and transferences, and uses free association and catharsis. Clinical practice requires licensure. |
| Notes: Sources: (1) Dorlands Illustrated Medical Dictionary, 28th Edition, W.B. Saunders Company: Philadelphia, 1994, p. 1382; (2)American Psychological Association, Washington, DC, 1997, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619086931 | Robert K. Becher | Psychologist | 1325 Wyoming Ne, Kaseman Behavioral Medicine, Albuquerque, NM 87112 | 2006-08-30 |
| 1669407698 | Mary E Trujillo | Psychologist | Pmg Cedar Neurosurgery, 201 Cedar Se, Albuquerque, NM 87106 | 2006-07-11 |
| 1760677553 | Celeste Frank Phd PC | Psychologist | 3044 Ole Ct Ne, Albuquerque, NM 87111-5624 | 2007-09-13 |
| 1346468923 | Jon Maaske | Psychologist | 3200 Carlisle Blvd Ne, Suite 227, Albuquerque, NM 87110-1600 | 2007-04-21 |
| 1255457156 | Claire E Logan | Psychologist | Pmg Kaseman Behavioral Medicine, 1325 Wyoming Ne, Albuquerque, NM 87112 | 2007-03-22 |
| 1922137298 | Robert E Moslow | Psychologist | 5901 Harper Dr Ne, Pmg Northside, Albuquerque, NM 87109 | 2007-03-05 |
| 1972661148 | Jeanne M Corns | Psychologist | 5550 Wyoming Blvd Ne, Pmg Wyoming, Albuquerque, NM 87109 | 2006-12-04 |
| 1891804126 | Jeanne Pierrot | Psychologist | Pmg Kaseman Behavioral Medicine, 1325 Wyoming Ne, Albuquerque, NM 87112 | 2006-08-30 |
| 1083723308 | Mary Miesem | Psychologist | Pmg Kaseman Behavioral Medicine, 1325 Wyoming Ne, Albuquerque, NM 87112 | 2006-08-30 |
| 1346359668 | Cynthia L Corbett | Psychologist | 1325 Wyoming Blvd Ne, Pmg Kaseman Behavioral Medicine, Albuquerque, NM 87112-5046 | 2006-08-30 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87112 |
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| 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.