Andrew Gallegos, CPSW

Individual provider Active NPI Peer Specialist · Espanola, NM

NPI 1356084560 · NPPES record last updated Apr 15, 2022

Key facts

NPI
1356084560
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
1000 N Paseo de Onate
Espanola, NM 87532-2683
Phone
(505) 983-6158
Fax
(505) 983-0460
NPI assigned
Apr 15, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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
Santa Fe Mountain Center Inc Past
since Apr 17, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X NM Yes

Addresses

Primary practice location

1000 N Paseo de Onate
Espanola, NM 87532-2683

Mailing address

PO Box 449
Tesuque, NM 87574-0449
Phone (505) 983-6158

Other providers in Espanola, NM

All providers in Espanola, NM · Peer Specialist in New Mexico

Sources for this page

Verify at the official NPI Registry.