Healthcare Provider Details

I. General information

NPI: 1447583935
Provider Name (Legal Business Name): CHRISTINE ALETHEA WADE-BECHER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 JUAN TABO BLVD NE STE E&F
ALBUQUERQUE NM
87112-1886
US

IV. Provider business mailing address

PO BOX 14837
ALBUQUERQUE NM
87191-4837
US

V. Phone/Fax

Practice location:
  • Phone: 505-220-3643
  • Fax: 855-764-7379
Mailing address:
  • Phone:
  • Fax: 505-220-3643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-07971
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-07971
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: