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Organization

CHRISTINA MARIE DOUGHERTY

Active
Other names
Christina Dougherty LCSW LLC
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINA MARIE DOUGHERTY LCSW (OWNER, CLINICIAN)
(858) 504-7868
Entity
Organization

Contact information

Practice address
10401 MONTGOMERY BLVD NE STE 2L, ALBUQUERQUE, NM 87111-3844
(858) 504-7868
Mailing address
1109 DASKALOS DR NE, ALBUQUERQUE, NM 87123-1938
(858) 504-7868

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6L2005
NM MEDICARE PTAN GROUP
NM
Enumeration date
02/06/2023
Last updated
12/11/2025
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