Joshua Atencio, CSW

Individual provider Active NPI Behavior Technician · Bloomfield, NM

NPI 1053993113 · NPPES record last updated Apr 27, 2021

Key facts

NPI
1053993113
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
101 E Broadway Ave
Bloomfield, NM 87413-6235
Phone
(505) 330-8220
NPI assigned
Apr 27, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Angel Peak Counseling, LLC Current
since May 16, 2021
Accepting new patients
Sadie L Smith-McDaniel Current
since May 16, 2021
Accepting new patients

Locations

101 E Broadway Ave
Bloomfield, NM 87413
Phone (505) 330-8220

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

101 E Broadway Ave
Bloomfield, NM 87413-6235

Mailing address

101 E Broadway Ave
Bloomfield, NM 87413-6235
Phone (505) 330-8220

Other providers in Bloomfield, NM

All providers in Bloomfield, NM · Behavior Technician in New Mexico

Sources for this page

Verify at the official NPI Registry.