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NPI Code Detail

MEDICARE: THREE HEARTS THERAPY LLC

MEDICARE: THREE HEARTS THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI-6807NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235487372
Entity Type Code : Organization
Provider Name (Legal Business Name) : THREE HEARTS THERAPY LLC
Provider Business Mailing Address
First Line : 2201 SAN PEDRO DR NE STE 100
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-4133
Country : US
Telephone Number : 505-503-1811
Fax Number : 505-639-4309
Provider Business Practice Location Address
First Line : 2424 JUAN TABO BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-1818
Country : US
Telephone Number : 505-503-1811
Fax Number : 505-274-7338
Authorized Official
Title or Position : PROPRIETOR
Name : ERIN M COLLINS
Credential : LISW
Telephone Number : 505-503-1811
Provider Enumeration Date : 08/21/2012
Last Update Date : 01/02/2025

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Directions to “THREE HEARTS THERAPY LLC ” Practice Location

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