MEDICARE: MOODS AND MESAS BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1043001019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOODS AND MESAS BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	208 E 18TH ST
Second Line	:
City	:	CIMARRON
State	:	NM
Zip	:	87714-5002
Country	:	US
Telephone Number	:	575-300-5729
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 1/2 S 3RD ST
Second Line	:
City	:	RATON
State	:	NM
Zip	:	87740
Country	:	US
Telephone Number	:	575-376-5468
Fax Number	:

Authorized Official
Title or Position	:	PMHNP-BC / OWNER
Name	:	AMANDA D STURGEON
Credential	:	PMHNP-BC
Telephone Number	:	575-300-5729

Provider Enumeration Date	:	05/16/2025
Last Update Date	:	03/27/2026

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