Organization
NEW MEXICO COUNSELING AND BRAIN HEALTH
Active
Organization
NEW MEXICO COUNSELING AND BRAIN HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER MARIE HARRISON-SANCHEZ LMSW (DIRECTOR OF PROGRAM DEVELOPMENT)
(505) 338-0720
Entity
Organization
Contact information
Practice address
6121 INDIAN SCHOOL RD NE STE 103, ALBUQUERQUE, NM 87110-4165
(505) 338-0720
Mailing address
6121 INDIAN SCHOOL RD NE STE 103, ALBUQUERQUE, NM 87110-4165
(505) 338-0720
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-08251
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277544
PTAN
NM
01
—
289538YQQA
MEDICARE MEMBER PROVIDER NUMBER
NM
Enumeration date
07/23/2013
Last updated
07/23/2013
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