MS. DEMETRA CHILDRESS MS NPI 1801959432

NPI Information

NPI: 1801959432
Provider Name: MS. DEMETRA CHILDRESS, MS
Classification: Counselor - 101YP2500X
Specialization: Professional
Entity Type: Individual
PECOS Registration: Yes
Address: 4425 JUAN TABO BLVD NE
SUITE 103
ALBUQUERQUE, NM
ZIP 87111
Phone: (505) 292-8908

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NPI Details

MS. Demetra Childress, MS is a professional counselor in Albuquerque, NM with 41 years of experience. MS. Demetra Childress, MS NPI is 1801959432. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4425 JUAN TABO BLVD NE
SUITE 103
ALBUQUERQUE, NM
ZIP 87111-681
Phone: (505) 292-8908
Fax: (505) 292-3109

The NPI 1801959432 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 12/18/2006 and was last updated on 6/15/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	0975	NEW MEXICO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01357573	MEDICAID	NEW MEXICO
2	NM101536	OTHER	NEW MEXICO	VALUE OPTIONS SALVD
3	201012073	OTHER	NEW MEXICO	PRESBYTERIAN HEALTH PLAN

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: 3/30/2025

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