Organization
BLUE SAGE COUNSELING AND PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL E. ADAMS LISW (PRESIDENT)
(505) 463-1829
Entity
Organization
Contact information
Practice address
1839 BETTS ST NE, ALBUQUERQUE, NM 87112-3103
(505) 463-1829
Mailing address
1839 BETTS ST NE, ALBUQUERQUE, NM 87112-3103
(505) 463-1829
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05493
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396894994
NPI
NM
05
—
33827028
—
NM
Enumeration date
09/13/2011
Last updated
09/13/2011
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