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SANTA FE SUPPORTIVE THERAPY LLC NPI 1043502388


NPI Information

NPI: 1043502388
Provider Name: SANTA FE SUPPORTIVE THERAPY, LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
1418 LUISA ST STE 5A
SANTA FE, NM
ZIP 87505
Phone: (505) 926-0906
Get Directions

SANTA FE SUPPORTIVE THERAPY, LLC is a clinical social worker in Santa Fe, NM. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. SANTA FE SUPPORTIVE THERAPY, LLC NPI is 1043502388. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1418 LUISA ST STE 5A
SANTA FE, NM
ZIP 87505-091
Phone: (505) 926-0906
Fax: (505) 926-0906

The provider's authorized official is Anika M Kelso .
The authorized official title is Owner/psychotherapist and has the following contact phone number (505) 926-0906.

The enumeration date for this NPI number is 5/4/2011 and was last updated on 1/29/2015.


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
11041C0700XSocial WorkerClinicalI-06699NEW 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
170372900MEDICAIDNEW 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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