ILLUMINE INTEGRATIVE THERAPEUTICS LLC (NPI# 1265965446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265965446 |
Entity Type | Organization |
Organization Name | ILLUMINE INTEGRATIVE THERAPEUTICS LLC |
Practice Address |
707 Broadway Blvd Ne Suite 402 Albuquerque NM 87102-2360 |
Mailing Address |
20 Santa Ana Loop Placitas NM 87043-9440 |
Practice Telephone | 5057962975 |
Mailing Telephone | 5057962975 |
Enumeration Date | 2017-04-05 |
Last Update Date | 2017-04-05 |
Authorized Official Name | JEANNE DALEN (OWNER) |
Authorized Official Telephone | 5057962975 |
Authorized Official Credential | PH.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251S00000X | Community/Behavioral Health | 1339 | NM | Agencies |
Street Address |
707 BROADWAY BLVD NE SUITE 402 |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87102-2360 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699880484 | David Jonathan Ley Jr. | Psychologist | 707 Broadway Blvd Ne, Ste 500, Albuquerque, NM 87102-2360 | 2006-08-20 |
1831798768 | Bethany Garling-spychala | Social Worker | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-10-21 |
1225637556 | Sharon Gissell Marin | Behavioral Analyst | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-10-19 |
1609475938 | Kayla Naomi Escobedo | Behavioral Analyst | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-10-19 |
1245837202 | Angel Sanchez | Behavioral Analyst | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-10-02 |
1225641228 | Madeline Chloe Slator | Behavioral Analyst | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-08-28 |
1629681390 | Madison D'shey Bean | Behavioral Analyst | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-08-24 |
1043821408 | Katryna Mitchell | Behavioral Analyst | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-08-11 |
1699383240 | Rebekah Renee Maestas | Counselor | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-07-20 |
1831714781 | Erica Lynn Rawson | Behavioral Analyst | 707 Broadway Blvd Ne, Albuquerque, NM 87102-2360 | 2020-06-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407454937 | Julie Wood | Acupuncturist | 1600 Luna Circle Nw, Albuquerque, NM 87102 | 2020-10-16 |
1770121410 | Emily Perez | Counselor | 218 Broadway Ne, Albuquerque, NM 87102 | 2019-12-12 |
1417503392 | Tess Holtry | Behavior Technician | 1424 Walter St Nw, Albuquerque, NM 87102 | 2019-08-15 |
1942867486 | Christy E Cheromiah | Behavioral Analyst | Open Skies Helathcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-05-21 |
1730744103 | Faith Petra Maxwell | Behavior Technician | 900 Arno St, Albuquerque, NM 87102 | 2019-05-01 |
1568923761 | Storm Swinford | Behavioral Analyst | Open Skies Healthcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-29 |
1093276651 | Tina Marie Trujillo | Behavioral Analyst | Open Skies Health Care, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-27 |
1861950370 | Meghan Montoya | Student in an Organized Health Care Education/Training Program | 801 Camino De Salud, Albuquerque, NM 87102 | 2019-03-05 |
1174099329 | Dilshani N Tyson | Counselor | 600 1st Street Nw Ste 200, Albuquerque, NM 87102 | 2018-10-15 |
1962987925 | Tania L Goldfeder | Social Worker | New Mexico Solutions, 707 Broadway Ne Suite 500, Albuquerque, NM 87102 | 2018-09-26 |
Find all providers in zip 87102 |
Taxonomy Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
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1396345328 | The People's Counseling and Consulting, LLC | Community/Behavioral Health | 4718 Idlewilde Ln Se, Albuquerque, NM 87108-3424 | 2020-10-28 |
1689271413 | Thriving Mind LLC | Community/Behavioral Health | 4612 Huyana Dr Nw, Albuquerque, NM 87120-5597 | 2020-10-05 |
1922612951 | Connections Counseling LLC | Community/Behavioral Health | 11920 Dahlia Ave Se, Albuquerque, NM 87123-2470 | 2020-09-08 |
1396360871 | Integrity Behavior Improvement Services, LLC | Community/Behavioral Health | 1916 Amherst Dr Ne, Albuquerque, NM 87106-1105 | 2020-06-10 |
1023647096 | Inner Peace Outreach LLC | Community/Behavioral Health | 3107 San Mateo Blvd Ne, Albuquerque, NM 87110-1921 | 2020-04-02 |
1285278242 | Albuquerque United LLC | Community/Behavioral Health | 1100 4th St Nw Ste A, Albuquerque, NM 87102-1416 | 2019-11-03 |
1376184150 | True Color Counseling, LLC | Community/Behavioral Health | 3539 Thaxton Ave Se # 3, Albuquerque, NM 87106-1628 | 2019-10-03 |
1164073102 | The Growth Place, LLC | Community/Behavioral Health | 301 Graceland Dr Se Ste B, Albuquerque, NM 87108-2778 | 2019-09-20 |
1952960312 | Love Is Healing, LLC | Community/Behavioral Health | 120 Dartmouth Dr Se Apt D, Albuquerque, NM 87106-2261 | 2019-06-10 |
1144786146 | Seed To Tree Counseling, LLC | Community/Behavioral Health | 104 Serenity Hills Pl Se, Albuquerque, NM 87123-3970 | 2019-02-14 |
Find all providers in ALBUQUERQUE |
City | ALBUQUERQUE |
Zip Code | 87102 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.