MEDICARE: CHRISTINA MARIE DOUGHERTY

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	1041C0700X	Clinical Social Worker

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6L2005	OTHER	NM	NM MEDICARE PTAN GROUP

General Provider Information

NPI Number	:	1952007304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINA MARIE DOUGHERTY

Provider Business Mailing Address
First Line	:	1109 DASKALOS DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87123-1938
Country	:	US
Telephone Number	:	858-504-7868
Fax Number	:

Provider Business Practice Location Address
First Line	:	10401 MONTGOMERY BLVD NE STE 2L
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3844
Country	:	US
Telephone Number	:	858-504-7868
Fax Number	:

Authorized Official
Title or Position	:	OWNER, CLINICIAN
Name	:	CHRISTINA MARIE DOUGHERTY
Credential	:	LCSW
Telephone Number	:	858-504-7868

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	12/11/2025

Similar Medicare Providers

1215525902 — AUGUST VOJDANI PA-C
Practice Location Address:

4588 PARADISE BLVD NW , MEDICARE ADVANTAGE CLINIC
ALBUQUERQUE, NM
87114-4105

Practice Phone: 505-998-1840
Practice Fax: 505-998-1841

1467534289 — MRS. CATHERINE MARY ELLIOTT RDH
Practice Location Address:

8104 CEDAR CREEK DR NW
ALBUQUERQUE, NM
87120-3844

Practice Phone: 505-615-0951
Practice Fax: 505-792-6737

1134264971 — ARCA - LOUISIANA
Practice Location Address:

615 LOUISIANA BLVD SE
ALBUQUERQUE, NM
87108-3844

Practice Phone: 505-332-6814
Practice Fax: 505-332-6800

1518266972 — DENTAL CARE IN YOUR HOME, INC.
Practice Location Address:

8104 CEDAR CREEK DR NW
ALBUQUERQUE, NM
87120-3844

Practice Phone: 505-615-0951
Practice Fax:

1265246813 — HENNESSEY COUNSELING AND CONSULTATION
Practice Location Address:

5728 CARMEN RD NW
ALBUQUERQUE, NM
87114-3844

Practice Phone: 505-259-7388
Practice Fax:

1780554402 — DUBLIN GULCH COUNSELING AND CONSULTATION
Practice Location Address:

5728 CARMEN RD NW
ALBUQUERQUE, NM
87114-3844

Practice Phone: 505-259-7388
Practice Fax: 505-259-7388

Directions to “CHRISTINA MARIE DOUGHERTY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.