HOLLY BAUER (NPI# 1972900967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972900967 |
Entity Type | Individual |
Full Name | HOLLY BAUER |
Credential | LISW |
Practice Address |
3405 Pan American Fwy Ne Albuquerque NM 87107-4786 |
Practice Telephone | 5052220331 |
Practice Fax Number | 5052220301 |
Mailing Telephone | 5052220331 |
Mailing Fax Number | 5052220301 |
Enumeration Date | 2014-11-19 |
Last Update Date | 2014-11-19 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | I-08531 | NM | Residential Treatment Facilities |
Street Address |
3405 PAN AMERICAN FWY NE |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87107-4786 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407990500 | Nm Department of Health | Residential Treatment Facility, Emotionally Disturbed Children | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2007-02-20 |
1295069219 | Merle Lee Pokempner | Counselor | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2009-09-23 |
1013241140 | Bryan Lance Hurt | Psychologist | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2009-09-22 |
1962736173 | Jude Christine Payne | Social Worker | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2009-09-22 |
1942534201 | William Henry Gardner | Psychologist | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2009-09-18 |
1366775728 | Victoria L. Sakshaug | Social Worker | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2009-09-16 |
1093048597 | Phyllis Mccurdy Denton | Counselor | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2009-09-15 |
1336261783 | Robert Anthony Buser | Psychiatry & Neurology | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2007-04-05 |
1548388291 | Kathryn Ann Daily | Speech-Language Pathologist | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2007-03-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619589785 | Benjamin Argant | Behavior Technician | 331 Candelaria Road North East Suite A, Albuquerque, NM 87107 | 2020-08-20 |
1679138861 | Susan Luna, Lpcc LLC | Counselor | 3221 B Candelaria Ne, Albuquerque, NM 87107 | 2019-05-03 |
1407310881 | Eleanor Cloe Tibbetts | Speech-Language Pathologist | 7103 4th St. Nw Chatterbox Speech Therapy, Los Ranchos, NM 87107 | 2019-01-30 |
1386174829 | Triple D Medical Transportation, LLC. | Secured Medical Transport (VAN) | 2123 Menaul Blvd Ne Ste B, Albuquerque, NM 87107 | 2017-06-18 |
1487100715 | Kayleen Weinandt | Community/Behavioral Health | 3301 Los Arboles Ne, Albuquerque, NM 87107 | 2016-08-28 |
1811345549 | Inverse Medical, LLC | Non-emergency Medical Transport (VAN) | 1015 Cottonwood Dr. Suite J, Albuquerque, NM 87107 | 2016-06-03 |
1710349220 | Evolv Strong, LLC | Specialist/Technologist | 3201 Candelaria Rd Ne, Albuquerque, NM 87107 | 2016-03-23 |
1982072443 | Erik Robinson | Social Worker | 7801 Academy Road, Ne 2-200, Albueruque, NM 87107 | 2015-09-14 |
1033505763 | Sam Newmon Ma, Lpcc | Counselor | 320-h Osuna Rd Ne, Suite 4, Albuquerque, NM 87107 | 2015-04-09 |
1760896203 | Jocelyn Fiaschetti | Social Worker | 7704 4th Street Nw, Albuquerque, NM 87107 | 2014-06-12 |
Find all providers in zip 87107 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407990500 | Nm Department of Health | Residential Treatment Facility, Emotionally Disturbed Children | 3405 Pan American Fwy Ne, Albuquerque, NM 87107-4786 | 2007-02-20 |
1699849794 | Cyfd-state of New Mexico | Residential Treatment Facility, Emotionally Disturbed Children | 3409 Pan American Fwy Ne, 3409 Pan American Frwy, Albuquerque, NM 87107-4786 | 2006-11-20 |
1720152838 | Cyfd-state of New Mexico-eagles Nest | Residential Treatment Facility, Emotionally Disturbed Children | 300 San Mateo Blvd Ne Ste 410, Albuquerque, NM 87108-1503 | 2006-11-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407376585 | Amikids Sandoval, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | #20 Pond Road, Sandoval, NM 87013 | 2017-06-21 |
1952549875 | Youth Odyssey Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 605 White Mountain Meadows Dr, Ruidoso, NM 88345-5816 | 2009-01-30 |
1770721292 | Casa Mesita Group Home, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4007 Sycamore St, Los Alamos, NM 87544-1728 | 2009-01-22 |
1942404090 | Zimmerman Consulting, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 15 Jemez Drive, Los Lunas, NM 87031-7624 | 2007-06-13 |
1497872550 | New Vision Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 919 Rencher St, Clovis, NM 88101-5858 | 2007-03-23 |
1124156815 | Villa Santa Maria | Residential Treatment Facility, Emotionally Disturbed Children | 19 Cirquela Rd, Cedar Crest, NM 87008 | 2007-03-02 |
1518010222 | Assurance Home Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1000 E 18th St, Roswell, NM 88201-7532 | 2007-01-18 |
1962569640 | Our Lady of Mount Carmel | Residential Treatment Facility, Emotionally Disturbed Children | 300 Mount Carmel Ave, Gallup, NM 87301-7411 | 2007-01-02 |
1306910484 | Cyfd-state of New Mexico-laplacita | Residential Treatment Facility, Emotionally Disturbed Children | 3102 N Florida Ave, Alamogordo, NM 88310-9713 | 2006-11-20 |
1881767366 | Cyfd-state of New Mexico-carlsbad Crf | Residential Treatment Facility, Emotionally Disturbed Children | 106 N Mesquite St, Carlsbad, NM 88220-4960 | 2006-11-15 |
Find all providers with the same taxonomy |
City | ALBUQUERQUE |
Zip Code | 87107 |
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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.