| Second Creation Inc. | |
|
1800 Old Pecos Trl Ste P Santa Fe NM 87505-4759 | |
| (505) 795-8447 | |
| (505) 213-0337 |
| Full Name | Second Creation Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1800 Old Pecos Trl Ste P, Santa Fe, New Mexico |
| Authorized Official Name and Position | Alexandra E Pitt (CEO) |
| Authorized Official Contact | 5057958447 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Creation Inc. 1800 Old Pecos Trl Ste P Santa Fe NM 87505-4759 Ph: (505) 795-8447 | Second Creation Inc. 1800 Old Pecos Trl Ste P Santa Fe NM 87505-4759 Ph: (505) 795-8447 |
| NPI Number | 1497120422 |
|---|---|
| Provider Enumeration Date | 12/02/2015 |
| Last Update Date | 07/28/2022 |
| Certification Date | 07/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497120422 | NPI | - | NPPES |
| 22027718 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0161941 (New Mexico) | Primary |
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