| Enlighten Up Therapeutic Services Llc | |
|
7050 Barstow St Ne Ste B Albuquerque NM 87111-1056 | |
| (505) 274-2946 | |
| Not Available |
| Full Name | Enlighten Up Therapeutic Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 7050 Barstow St Ne Ste B, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jennifer Mcgough (OWNER) |
| Authorized Official Contact | 5052742946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enlighten Up Therapeutic Services Llc 11133 Academy Ridge Rd Ne Albuquerque NM 87111-6868 Ph: (505) 274-2946 | Enlighten Up Therapeutic Services Llc 7050 Barstow St Ne Ste B Albuquerque NM 87111-1056 Ph: (505) 274-2946 |
| NPI Number | 1417591793 |
|---|---|
| Provider Enumeration Date | 10/30/2019 |
| Last Update Date | 05/13/2025 |
| Certification Date | 05/13/2025 |
| Medicare PECOS PAC ID | 1355887035 |
|---|---|
| Medicare Enrollment ID | O20240718003592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417591793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jennifer Ann Mcgough |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831473701 PECOS PAC ID: 2264978949 Enrollment ID: I20240718003823 |
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