Organization
MOSAIC COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE K GRAY LCSW (OWNER)
(505) 720-3781
Entity
Organization
Contact information
Practice address
1921 CARLISLE BLVD NE STE A, ALBUQUERQUE, NM 87110-4971
(505) 750-4243
Mailing address
4804 OVERLAND ST NE, ALBUQUERQUE, NM 87109-2667
(505) 750-4243
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40488063
—
NM
Enumeration date
10/15/2020
Last updated
03/31/2025
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