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General NPI Number Information
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NPI Number | 1134442270
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Entity Type | Organization
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Legal Business Name | ESSENTIAL MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 2601 WYOMING BLVD NE SUITE 208
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-1035
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Country | US
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Telephone | 505-503-0272
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Fax | 505-503-1859
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Provider Business Mailing Address
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Address Line | 2601 WYOMING BLVD NE STE 208
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-1033
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Country | US
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Telephone | 505-503-0272
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Fax | 505-503-1859
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ANNE GLADDEN SNYDER
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Credential | LCSW
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Telephone | 505-503-0272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | FA0092024
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License Number State | NM
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