Organization
MADELEINE N STEVENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADELEINE NOEL STEVENS (OWNER/PSYCHOTHERAPIST)
(505) 385-5281
Entity
Organization
Contact information
Practice address
301 S CAMINO DEL PUEBLO, BERNALILLO, NM 87004-6276
(505) 385-5281
Mailing address
9 CAMINO DE SAN FELIPE, PLACITAS, NM 87043-9388
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
0106661
NM
251S00000X
Community/Behavioral Health Agency
Primary
0121691
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10325549
—
NM
Enumeration date
01/01/2017
Last updated
01/01/2017
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