Healthcare Provider Details

I. General information

NPI: 1184487092
Provider Name (Legal Business Name): TOTAL PSYCHIATRIC-MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 ATRISCO DR NW STE A
ALBUQUERQUE NM
87120-1609
US

IV. Provider business mailing address

3801 ATRISCO DR NW STE A
ALBUQUERQUE NM
87120-1609
US

V. Phone/Fax

Practice location:
  • Phone: 505-397-8212
  • Fax:
Mailing address:
  • Phone: 505-492-9598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAUD NELSON
Title or Position: DNP,CNP, PMHNP-BC
Credential:
Phone: 505-492-9598