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Contact Information

MEDITELECARE OF NEW MEXICO, LLC
206 S CORONADO AVE
ESPAÑOLA, NM87532-2792
 Phone: 860-788-6404
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MEDITELECARE OF NEW MEXICO LLC · (Female)

NPI Number 1629639729
Status Active
Credentials
Entity Individual
Enumeration date 06/28/2019
Last updated 05/05/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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