Healthcare Provider Details
I. General information
NPI: 1689246688
Provider Name (Legal Business Name): GOLD PERSPECTIVE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2021
Last Update Date: 12/15/2024
Certification Date: 12/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9400 HOLLY AVE NE BLDG 4
ALBUQUERQUE NM
87122-2969
US
IV. Provider business mailing address
3 BLUE BONNET DR
LOS LUNAS NM
87031-6750
US
V. Phone/Fax
- Phone: 505-336-0403
- Fax:
- Phone: 505-930-0752
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHOLE
STRASSER
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 505-336-0403