MEDICARE: FORENSIC BEHAVIORAL HEALTH ASSOCIATES

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
1	101YM0800X	Mental Health Counselor	08028036	NM

Other Identifiers

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

General Provider Information

NPI Number	:	1376577221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORENSIC BEHAVIORAL HEALTH ASSOCIATES

Provider Business Mailing Address
First Line	:	10409 MONTGOMERY PARKWAY WEST NE
Second Line	:	SUITE 102
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87199-2002
Country	:	US
Telephone Number	:	505-888-5499
Fax Number	:	505-888-5498

Provider Business Practice Location Address
First Line	:	10409 MONTGOMERY PKWY NE
Second Line	:	WEST NE. SUITE 102
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3852
Country	:	US
Telephone Number	:	505-888-5499
Fax Number	:	505-888-5498

Authorized Official
Title or Position	:	AGENCY DIRECTOR
Name	:	DR. TROY J. RODGERS
Credential	:	PSY.D. LPCC
Telephone Number	:	505-888-5499

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/22/2020

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Directions to “FORENSIC BEHAVIORAL HEALTH ASSOCIATES ” Practice Location

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