Healthcare Provider Details

I. General information

NPI: 1003724238
Provider Name (Legal Business Name): NEW MEXICO PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 GOLD AVE SW STE 707
ALBUQUERQUE NM
87102-3283
US

IV. Provider business mailing address

400 GOLD AVE SW STE 707
ALBUQUERQUE NM
87102-3283
US

V. Phone/Fax

Practice location:
  • Phone: 646-470-1786
  • Fax:
Mailing address:
  • Phone: 646-470-1786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LINNEA MICHAELS
Title or Position: CEO
Credential: LCSW
Phone: 917-387-7482