Kersten Counseling Center, Llc | |
10701 Lomas Blvd Ne Suite 204 Albuquerque NM 87112-5463 | |
(505) 550-9255 | |
(505) 298-2900 |
Full Name | Kersten Counseling Center, Llc |
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Speciality | Social Worker |
Location | 10701 Lomas Blvd Ne, Albuquerque, New Mexico |
Authorized Official Name and Position | Suzanne H. Kersten (OWNER) |
Authorized Official Contact | 5055509255 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kersten Counseling Center, Llc 10701 Lomas Blvd Ne Suite 204 Albuquerque NM 87112-5463 Ph: (505) 550-9255 | Kersten Counseling Center, Llc 10701 Lomas Blvd Ne Suite 204 Albuquerque NM 87112-5463 Ph: (505) 550-9255 |
NPI Number | 1376704262 |
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Provider Enumeration Date | 06/23/2008 |
Last Update Date | 06/23/2008 |
Medicare PECOS PAC ID | 1557401965 |
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Medicare Enrollment ID | O20091216000119 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376704262 | NPI | - | NPPES |
804636 | Other | NM | MAGELLAN |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | I-05378 (New Mexico) | Primary |
Provider Name | Suzanne H Kersten |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194891614 PECOS PAC ID: 4284774696 Enrollment ID: I20091216000113 |
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