Blue Phoenix Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

BLUE PHOENIX THERAPY LLC

Practice address

1740 Grande Blvd SE Ste D-4
Rio Rancho, NM 87124-1799

Phone

(505) 219-1028

NPI assigned

Mar 25, 2022

Last updated

Aug 29, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angela M BarelaNPI 1811238975

Title

Owner

Phone

(505) 219-1028

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela M Barela

  • Counselor
  • Rio Rancho, NM
  • NPI 1811238975
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1043960636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 GRANDE BLVD SE STE D-4",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241799",
            "telephone_number": "505-219-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 GRANDE BLVD SE STE D-4",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241799",
            "telephone_number": "505-219-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE PHOENIX THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-25",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "BARELA",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-219-1028"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01354353",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina D Blea
• Walter Anthony Blea, CASE MANAAGER
• Brian Duane Blocker, LPCC
• Bloom Haven Behavioral Health LLC
• Carrie Joanne Bloomer, RN
• Blueeyes Speech and Language Services (Connect With Autism)
• William K Blythe, LPCC
• Victoria L Bobchak
• Steven N Bock, MD
• Rhonda Bodewaldt

• Professional Counselor in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.