Organization
CHANGING PERSPECTIVES YOUTH AND FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO PICHA LCSW (PSYCHOTHERAPIST/SOCIAL WORKER)
(505) 366-9106
Entity
Organization
Contact information
Practice address
4312 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4811
(505) 366-9106
Mailing address
3524 RIO GRANDE BLVD NW, ALBUQUERQUE, NM 87107-3038
(505) 366-9106
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C09396
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05552893
—
NM
05
—
83230513
—
NM
Enumeration date
04/18/2016
Last updated
07/11/2016
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