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SANTA FE PSYCHOLOGICAL SERVICES LLC NPI 1396950390


NPI Information

NPI: 1396950390
Provider Name: SANTA FE PSYCHOLOGICAL SERVICES LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
1807 2ND ST
SUITE 44
SANTA FE, NM
ZIP 87505
Phone: (505) 577-2607
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SANTA FE PSYCHOLOGICAL SERVICES LLC is a clinical psychologist in Santa Fe, NM. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. SANTA FE PSYCHOLOGICAL SERVICES LLC NPI is 1396950390. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1807 2ND ST
SUITE 44
SANTA FE, NM
ZIP 87505-499
Phone: (505) 577-2607
Fax: (505) 982-1096

The provider's authorized official is Ernesto Felix Santistevan .
The authorized official title is Clinical Director and has the following contact phone number (505) 577-2607.

The enumeration date for this NPI number is 5/11/2007 and was last updated on 7/31/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical688NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1Z0874MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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