| High Desert Healing | |
|
4201 Carlisle Blvd Ne Albuquerque NM 87107-4808 | |
| (505) 717-1332 | |
| Not Available |
| Full Name | High Desert Healing |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4201 Carlisle Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Lauren Gomez (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5057171332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| High Desert Healing 4201 Carlisle Blvd Ne Albuquerque NM 87107-4808 Ph: (505) 717-1332 | High Desert Healing 4201 Carlisle Blvd Ne Albuquerque NM 87107-4808 Ph: (505) 717-1332 |
| NPI Number | 1265938203 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 12/13/2024 |
| Certification Date | 11/15/2024 |
| Medicare PECOS PAC ID | 2769711050 |
|---|---|
| Medicare Enrollment ID | O20190911003527 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265938203 | NPI | - | NPPES |
| 96284374 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | C-06315 (New Mexico) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Russell Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205028321 PECOS PAC ID: 4587758388 Enrollment ID: I20070925000232 |
| Provider Name | Lauren Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619489564 PECOS PAC ID: 4284963570 Enrollment ID: I20200225000162 |
| Provider Name | Shashwat A Pandhi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760749600 PECOS PAC ID: 4587898200 Enrollment ID: I20200721000278 |
| Provider Name | Adam Vareika |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093985392 PECOS PAC ID: 8224214440 Enrollment ID: I20200914002142 |
| Provider Name | Mikaella Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477338341 PECOS PAC ID: 0840649844 Enrollment ID: I20231215003408 |
| Provider Name | Aubrey Stallings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750965109 PECOS PAC ID: 0840633855 Enrollment ID: I20240207000373 |
| Provider Name | Jessey Stallings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669056917 PECOS PAC ID: 6204271455 Enrollment ID: I20240228001301 |
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