Healthcare Provider Details

I. General information

NPI: 1932698875
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHOLOGY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 W BROADWAY ST
SILVER CITY NM
88061-4925
US

IV. Provider business mailing address

1513 SAN CARLOS RD SW
ALBUQUERQUE NM
87104-1042
US

V. Phone/Fax

Practice location:
  • Phone: 575-574-0267
  • Fax: 575-388-1035
Mailing address:
  • Phone: 575-574-0267
  • Fax: 575-388-1035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1210
License Number StateNM

VIII. Authorized Official

Name: DR. LISA HOUSTON
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 575-574-0267