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NPI Code Detail

MEDICARE: EL PASO PSYCHIATRIC ASSOCIATES PA

MEDICARE: EL PASO PSYCHIATRIC ASSOCIATES PA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP2500XProfessional Counselor
3106H00000XMarriage & Family Therapist
4171M00000XCase Manager/Care Coordinator
5363LP0808XPsychiatric/Mental Health Nurse Practitioner
62084P0800XPsychiatry Physician
7101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1922480524
Entity Type Code : Organization
Provider Name (Legal Business Name) : EL PASO PSYCHIATRIC ASSOCIATES PA
Provider Business Mailing Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-757-7999
Fax Number : 915-757-8004
Provider Business Practice Location Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-757-7999
Fax Number : 915-757-8004
Authorized Official
Title or Position : CEO
Name : CAROL J ANDERSON-JIMENEZ
Credential : MSN, PHD, LCDC, RN-P
Telephone Number : 915-757-7999
Provider Enumeration Date : 06/19/2015
Last Update Date : 06/15/2016

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