Organization
GD PSYCH SERVICES, LLC
Active
Other names
GD Psych Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY L GOLDSTEIN-DWYER PSYD, MA (OWNER)
(505) 218-6383
Entity
Organization
Contact information
Practice address
2200 GRANDE BLVD SE STE B, RIO RANCHO, NM 87124-1695
(505) 218-6383
(774) 221-9193
Mailing address
2200 GRANDE BLVD SE STE B, RIO RANCHO, NM 87124-1695
(505) 218-6383
(774) 221-9193
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
174H00000X
Health Educator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98336843
—
NM
Enumeration date
09/10/2018
Last updated
06/25/2021
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