Healthcare Provider Details

I. General information

NPI: 1700409968
Provider Name (Legal Business Name): CAA CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1448 S ST. FRANCIS DRIVE
SANTA FE NM
87505
US

IV. Provider business mailing address

P.O. BOX 6958
SANTA FE NM
87502
US

V. Phone/Fax

Practice location:
  • Phone: 505-231-6614
  • Fax:
Mailing address:
  • Phone: 505-231-6614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CECELIA A ALBERT
Title or Position: PRESIDENT/OWNER
Credential: MA, LPCC
Phone: 505-231-6614