Inner Peak Youth Counseling, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

INNER PEAK YOUTH COUNSELING, LLC

Practice address

11000 Candelaria Rd NE
Albuquerque, NM 87112-1751

Phone

(505) 600-5803

NPI assigned

Jun 21, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Jason Wade Burney, LPCC

Title

Ceo

Phone

(505) 600-5803

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1386138451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 KENTUCKY ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084942",
            "telephone_number": "505-600-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 CANDELARIA RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121751",
            "telephone_number": "505-600-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER PEAK YOUTH COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "BURNEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-600-5803",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Adolescent and Children Mental Health Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.