TELEMENTAL HEALTH LINK LLC (NPI# 1437783529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437783529 |
| Entity Type | Organization |
| Organization Name | TELEMENTAL HEALTH LINK LLC |
| Other Organization Name | PSYCHIATRIC NURSE PRACTITIONER SERVICES, LLC |
| Practice Address |
Telemental Health Link LLC 5700 Harper Dr Ne, #27 Albuquerque NM 87109-3573 |
| Mailing Address |
1651 E 70th St # 382 Shreveport LA 71105-5115 |
| Practice Telephone | 3185605883 |
| Practice Fax Number | 3182163940 |
| Mailing Telephone | 3188487114 |
| Mailing Fax Number | 3182163940 |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-06-16 |
| Authorized Official Name | MS. SUSAN MARIE DERIVAS (MEMBER) |
| Authorized Official Telephone | 3185605883 |
| Authorized Official Credential | CNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | DEA | MD1241859 | 01 |
| NCSBN ID | 1529234 | 01 | |
| LA | 1032026 | 05 | |
| LA | TAXONOMIES: NURSE PRACTITIONER PSYCH MENTAL HEALTH | 363LP0808X | 01 |
| LA | UPIN | P69441 | 01 |
| NM | NEW MEXICO APRN CNP LICENSE | 58322 | 01 |
| Other Name | Type Code |
|---|---|
| Psychiatric Nurse Practitioner Services, LLC | Other Name - Individual/Organization |
| Street Address |
TELEMENTAL HEALTH LINK LLC 5700 HARPER DR NE, #27 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-3573 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524727 | Clarissa Juarez, LLC | Nurse Practitioner | 3900 Juan Tabo Blvd Ne Ste 4, Albuquerque, NM 87111-3978 | 2020-09-26 |
| 1053933721 | Canu Health, LLC | Nurse Practitioner | 2621 Cutler Ave Ne, Albuquerque, NM 87106-2511 | 2020-05-15 |
| 1245869130 | Indigo Psychiatric Services | Nurse Practitioner | 609 Gold Ave Sw Ste 1-c, Albuquerque, NM 87102-3119 | 2020-04-03 |
| 1194388496 | Anne E. Galanis | Nurse Practitioner | 100 Deputy Dean Miera Dr Sw: Bernalillo County Metropol, Albuquerque, NM 87151 | 2019-04-22 |
| 1790214344 | La Paloma Clinic LLC | Nurse Practitioner | 431 Gene Ave Nw, Albuquerque, NM 87107-5320 | 2017-06-07 |
| 1437493020 | Sarah Michael Workman | Nurse Practitioner | 1501 San Pedro Drive Se, Bld 47, 377mdg/mdos/sgow, Albuquerque, NM 87117 | 2012-11-20 |
| 1437407301 | Jayanna Warwick | Nurse Practitioner | 2015 Wyoming Blvd Ne, Suite F, Albuquerque, NM 87112-2622 | 2012-08-26 |
| 1780939975 | Brenda Kaye Mckenna | Nurse Practitioner | Unm Department of Psychiatry and Behavioral Health Scie, 1 University of New Mexico, Albuquerque, NM 87131 | 2012-07-13 |
| 1194091603 | Awareness Integration LLC | Nurse Practitioner | 219 Sierra Dr Se, Unit A, Albuquerque, NM 87108-2714 | 2012-03-29 |
| 1003148156 | Maureen Kolomeir | Nurse Practitioner | 5345 Wyoming Blvd, Suite 101, Albuquerque, NM 87109-3193 | 2010-01-30 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
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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.