Meditelecare of New Mexico, LLC
NPI #1629639729 in Espanola, New Mexico
Provider Information
- NPI Number
- 1629639729
- Entity Type
- Organization
- Organization Name
- Meditelecare of New Mexico, LLC
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Jun 28, 2019
- Last Updated
- May 5, 2025
Practice Location
- Address
- 206 S CORONADO AVE
- City
- Espanola
- State
- New Mexico
- ZIP Code
- 87532-2792
- Phone
- (860) 788-6404
Authorized Official
- Name
- ANDREA GODFREY
- Title
- CREDENTIALING & ENROLLMENT MANAGER
- Phone
- (860) 398-6441
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
| Social Worker - Clinical — Clinical |
| Psychiatry & Neurology - Geriatric Psychiatry — Geriatric Psychiatry |
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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