PSYCHOGENESIS LLC (NPI# 1922646595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922646595 |
| Entity Type | Organization |
| Organization Name | PSYCHOGENESIS LLC |
| Other Organization Name | PSYCHOGENESIS |
| Practice Address |
3900 Eubank Blvd Ne Ste 18 Albuquerque NM 87111-3427 |
| Mailing Address |
Po Box 93274 Albuquerque NM 87199-3274 |
| Practice Telephone | 5055853744 |
| Enumeration Date | 2019-12-14 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | JAVIER VERA (OWNER) |
| Authorized Official Telephone | 5055853744 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Psychogenesis | Doing Business As Name - Organization |
| Street Address |
3900 EUBANK BLVD NE STE 18 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87111-3427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417438110 | Dehlen LLC | Counselor | 11000 Spain Rd Ne, Building E, Albuquerque, NM 87111 | 2018-08-22 |
| 1003313008 | Jessika Junick | Nurse Practitioner | 3825 Eubank Blvd Ne Ste A, Albuquerque, NM 87111 | 2018-04-07 |
| 1881113454 | Hayley Aragon-bell | Day Training/Habilitation Specialist | 3732 Mount Rainier Dr. Ne, Albuquerque, NM 87111 | 2017-09-14 |
| 1750803326 | Sarah Mckenzie Ochoa | Day Training/Habilitation Specialist | 3916 Garcia St Ne, Albuquerque, NM 87111 | 2017-07-14 |
| 1285179549 | Family Dental Health Care | Dentist | 4550 Eubank Blvd, Suite 203, Albuquerque, NM 87111 | 2016-12-22 |
| 1871036202 | Shobha Jagannath | Nurse Practitioner | 10700 Academy Rd Ne Apt 216, Albuquerque, NM 87111 | 2016-12-03 |
| 1508319310 | Mariana Boitano | Licensed Practical Nurse | 5400 Gibson Blvd., Albuquerque, NM 87111 | 2016-07-28 |
| 1184011082 | Adam Halpern | Specialist/Technologist | 4204 Parsifal St, Albuquerque, NM 87111 | 2015-04-20 |
| 1083015770 | Cvs Pharmacy | Public Health or Welfare | 5516 Camino Arbustos Ne, Albuquerque, NM 87111 | 2014-09-12 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in zip 87111 | ||||
| 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 |
|---|---|---|---|---|
| 1982219499 | Chrysalis Healthcare LLC | Psychiatry & Neurology | 2632 Mesilla St Ne Ste 6, Albuquerque, NM 87110-3614 | 2020-09-11 |
| 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 |
| 1386083368 | Jeannette Elizabeth Ferguson | Psychiatry & Neurology | Child Psychiatric Center 1001 Yale Blvd Ne, Albuquerque, NM 87131 | 2013-06-23 |
| 1245573476 | Dyani Loo | Psychiatry & Neurology | Msc 09 5030 University of New Mexico, Albuquerque, NM 87131 | 2013-04-06 |
| 1346528866 | Christie Anne Cline | Psychiatry & Neurology | 8905 Osuna Rd Ne, Albuquerque, NM 87111-2139 | 2011-08-01 |
| 1083904023 | Nina E Higgins | Psychiatry & Neurology | Msc 09 5030 1 University of New Mexico, Albuquerque, NM 87131 | 2011-04-11 |
| 1003111873 | Melissa A Merhege | Psychiatry & Neurology | 500 Walter St Ne Ste 213, Albuquerque, NM 87102 | 2011-01-25 |
| 1376869123 | Shanna Vaughan Diaz | Psychiatry & Neurology | 2600 Marble St, Albuquerque, NM 87131-0001 | 2010-04-19 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87111 |
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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.