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NPI Code Detail

MEDICARE: ZIA BEHAVIORAL HEALTH, LLP

MEDICARE: ZIA BEHAVIORAL HEALTH, LLP
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
1103TB0200XCognitive & Behavioral Psychologist06-03806NM

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 : 1316059314
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZIA BEHAVIORAL HEALTH, LLP
Provider Business Mailing Address
First Line : PO BOX 28220
Second Line :
City : SANTA FE
State : NM
Zip : 87592-8220
Country : US
Telephone Number : 505-820-0262
Fax Number : 505-820-9220
Provider Business Practice Location Address
First Line : 2504 CAMINO ENTRADA
Second Line :
City : SANTA FE
State : NM
Zip : 87507-4851
Country : US
Telephone Number : 505-820-0262
Fax Number : 505-820-9220
Authorized Official
Title or Position : MANAGING PARTNER
Name : SHANNON W FREEDLE
Credential :
Telephone Number : 505-820-0262
Provider Enumeration Date : 08/31/2006
Last Update Date : 05/05/2009

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Directions to “ZIA BEHAVIORAL HEALTH, LLP ” Practice Location

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