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General NPI Number Information
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NPI Number | 1669402103
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Entity Type | Individual
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Provider Name | CHRISTOPHER TODD CLANCY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 103 S SAINT FRANCIS DR UNIT B
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City | SANTA FE
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State | NM
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Zip | 87501-3055
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Country | US
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Telephone | 505-370-4294
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Fax | 505-212-1552
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Provider Business Mailing Address
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Address Line | 103 S SAINT FRANCIS DR UNIT B
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City | SANTA FE
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State | NM
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Zip | 87501-3055
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Country | US
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Telephone | 505-370-4294
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Fax | 505-212-1552
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | DR.0064112
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 210202
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD2005-0845
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 210202
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License Number State | MA
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