Provider Type Icon

ELEMENTAL HEALTH AND WELLNESS CENTER LLC NPI 1891125183


NPI Information

NPI: 1891125183
Provider Name: ELEMENTAL HEALTH AND WELLNESS CENTER LLC
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Organization

CLIA Number: 32D2251366

Address:
4425 JUAN TABO BLVD NE STE 112
ALBUQUERQUE, NM
ZIP 87111
Phone: (505) 503-6800
Get Directions

ELEMENTAL HEALTH AND WELLNESS CENTER LLC is a marriage family therapist in Albuquerque, NM. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. ELEMENTAL HEALTH AND WELLNESS CENTER LLC NPI is 1891125183. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4425 JUAN TABO BLVD NE STE 112
ALBUQUERQUE, NM
ZIP 87111-684
Phone: (505) 503-6800

The provider's authorized official is Anne Cannon .
The authorized official title is Owner and has the following contact phone number (505) 503-6800.

The CLIA number assigned to this NPI record is 32D2251366 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2013 and was last updated on 10/13/2023.


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
1101YM0800XCounselorMental Health0112181NEW MEXICONo
2207Q00000XFamily MedicineNo
3261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
4363LP0808XNurse PractitionerPsychiatric/Mental HealthCNP-02033NEW MEXICONo
5106H00000XMarriage & Family Therapist0084711NEW MEXICOYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.