Pagoda Behavioral Health LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PAGODA BEHAVIORAL HEALTH LLC

Practice address

1203 Iron Ave SW Apt 2
Albuquerque, NM 87102-3784

Phone

(505) 795-0706

NPI assigned

Feb 4, 2025

Last updated

Feb 4, 2025By 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

Fernando Ortiz

Title

Credentialing Manager

Phone

(575) 707-8150

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1164236782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 IRON AVE SW APT 2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 IRON AVE SW APT 2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023784",
            "telephone_number": "505-795-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGODA BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "575-707-8150"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Pagano
• Andrea Page, LPN
• Faith Page
• Giang Page
• Lisa R Page, DPT
• Michael L Pahos, LCSW
• Hemanth K Pai, MD
• Sunil Tonse Pai, M.D.
• Agnes Paijebo
• Pain and Addiction Services, LLC

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.