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General NPI Number Information
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NPI Number | 1417189945
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Entity Type | Organization
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Legal Business Name | COUNSELING & PSYCHOTHERAPY SERVICES, LLC
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Dates
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Enumeration Date | 08/17/2009
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Last Update Date | 08/17/2009
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Provider Practice Location Address
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Address Line | 2418 MILES RD SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-3224
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Country | US
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Telephone | 505-948-6602
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Fax | 505-842-1503
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Provider Business Mailing Address
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Address Line | 2127 RIO GRANDE BLVD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87104-2565
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Country | US
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Telephone | 505-948-6602
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Fax | 505-842-1503
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | SARA H. MCGEE
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Credential | MA, MFA, ATR, MSW
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Telephone | 505-948-6602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2595
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I04783
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License Number State | NM
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