MEDITELECARE OF NEW MEXICO, LLC (NPI# 1629639729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629639729 |
| Entity Type | Organization |
| Organization Name | MEDITELECARE OF NEW MEXICO, LLC |
| Practice Address |
206 S Coronado Ave Espanola NM 87532-2792 |
| Mailing Address |
Po Box 1595 Middletown CT 06457-8095 |
| Practice Telephone | 8607886404 |
| Practice Fax Number | 8608290495 |
| Mailing Telephone | 8607886404 |
| Mailing Fax Number | 8608290495 |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2019-06-28 |
| Authorized Official Name | TERESA PEARL TROJANOWSKI (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Telephone | 8607886404 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
206 S CORONADO AVE |
| City | ESPANOLA |
| State | NM |
| Zip Code | 87532-2792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720690423 | David A. Bustos | Non-emergency Medical Transport (VAN) | 1736 Calle Culebra, Espanola, NM 87532 | 2020-08-24 |
| 1407484942 | Rosita Lorreyna Sanchez | Behavior Technician | 3 Calle Baca, Espanola, NM 87532 | 2020-03-30 |
| 1437615564 | Troy Campbell | Counselor | 19525 Tomas Ln, Espanola, NM 87532 | 2019-02-13 |
| 1174099428 | Marisa Anaya | Registered Nurse | 420 N Coronado Ave, Espanola, NM 87532 | 2018-10-15 |
| 1780169938 | Celina Velasquez | Specialist/Technologist | 8 Camino Velasquez Ln., Espanola, NM 87532 | 2018-10-03 |
| 1356864656 | Jacqueline Andrea Zamora Alvarado | Behavior Technician | 3 Boneyard Rd, Espanola, NM 87532 | 2017-07-19 |
| 1619423902 | Mariah Maureen Martinez | Specialist/Technologist | 1421 Montana Vista St, Espanola, NM 87532 | 2016-08-28 |
| 1851847180 | Shannon Vigil | Perfusionist | 829 Calle Juan Jose Vigil, Espanola, NM 87532 | 2016-08-28 |
| 1144684234 | Tanya P. Reyes | Family Medicine | El Centro Family Health, 2010 Industrial Park Rd., Espanola, NM 87532 | 2016-04-05 |
| 1780058768 | Kale Lee Dennis | Massage Therapist | 2 Old Orchard Ln, Espanola, NM 87532 | 2015-11-13 |
| Find all providers in zip 87532 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013016534 | Rick Jan Strassman | Psychiatry & Neurology | 1206 N Riverside Dr, Espanola, NM 87532-2811 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982219499 | Chrysalis Healthcare LLC | Psychiatry & Neurology | 2632 Mesilla St Ne Ste 6, Albuquerque, NM 87110-3614 | 2020-09-11 |
| 1386283943 | Luxe Psychiatric and Wellness Services LLC | Psychiatry & Neurology | 613 W 2nd St Ste 3, Roswell, NM 88201-4671 | 2019-12-31 |
| 1386283869 | New Age Behavioral Health, LLC | Psychiatry & Neurology | 3600 Rodeo Ln Ste 5, Santa Fe, NM 87507-6400 | 2019-12-31 |
| 1922646595 | Psychogenesis LLC | Psychiatry & Neurology | 3900 Eubank Blvd Ne Ste 18, Albuquerque, NM 87111-3427 | 2019-12-14 |
| 1255991428 | Robert Charles Larsen | Psychiatry & Neurology | 7 Paintbrush Cir, Santa Fe, NM 87506-9539 | 2019-06-19 |
| 1316391063 | North Star Psychiatric Services, LLC | Psychiatry & Neurology | 1475 Central Ave, Suite 210, Los Alamos, NM 87544-3160 | 2016-04-19 |
| 1063891307 | Lynnet M Bulambo | Psychiatry & Neurology | 613 W 2nd St # 1&3, Roswell, NM 88201-4671 | 2015-05-20 |
| 1134515737 | Amanda S Valone | Psychiatry & Neurology | 1501 San Pedro Dr Se Rm 145, Albuquerque, NM 87108-5180 | 2015-04-09 |
| 1932514288 | Christine M Clark | Psychiatry & Neurology | 1 University of New Mexico # 95030, Albuquerque, NM 87131-0001 | 2014-06-25 |
| 1790105369 | Monique Elise Ethne Simpson | Psychiatry & Neurology | 320 Gold Ave Sw Ste 1001, Albuquerque, NM 87102-3228 | 2014-04-22 |
| Find all providers with the same taxonomy | ||||
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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.