Healthcare Provider Details
I. General information
NPI: 1992500094
Provider Name (Legal Business Name): THE GOLD STANDARD MENTAL HEALTH INSTITUTE, P.C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 LADERA RD
SANTA FE NM
87508-8301
US
IV. Provider business mailing address
30 CHUSCO RD
SANTA FE NM
87508-8779
US
V. Phone/Fax
- Phone: 505-289-7115
- Fax:
- Phone: 505-289-7115
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
JUIANA
F
RODRIGUEZ
Title or Position: DIRECTOR/ PRESIDENT
Credential: LMFT
Phone: 505-289-7115