Healthcare Provider Details

I. General information

NPI: 1447007562
Provider Name (Legal Business Name): MARY HOBBS PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4686 CORRALES RD STE 2
CORRALES NM
87048-8658
US

IV. Provider business mailing address

PO BOX 1268
CORRALES NM
87048-1268
US

V. Phone/Fax

Practice location:
  • Phone: 505-507-2902
  • Fax:
Mailing address:
  • Phone: 505-507-2902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY CLAIRE HOBBS
Title or Position: OWNER
Credential: LPCC
Phone: 505-507-2902