Organization Active NPI

Third Wave Psychotherapy of New Mexico

  • Adult Mental Health Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1407730609
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
THIRD WAVE PSYCHOTHERAPY OF NEW MEXICO
Practice address
10400 Academy Rd NE Ste 345
Albuquerque, NM 87111-7351
Phone
(505) 345-6100
Fax
(505) 212-0042
NPI assigned
Aug 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Authorized official

Name
Rae Littlewood, PHDNPI 1851697973
Title
Owner
Phone
(505) 977-7972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

10400 Academy Rd NE Ste 345
Albuquerque, NM 87111-7351

Mailing address

10400 Academy Rd NE Ste 345
Albuquerque, NM 87111-7351
Phone (505) 345-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251114003078 NM Part B Supplier - Clinic/Group Practice 3678064821 Receives reassigned benefits from 4 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1407730609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 ACADEMY RD NE STE 345",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871117351",
            "telephone_number": "505-345-6100",
            "fax_number": "505-212-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 ACADEMY RD NE STE 345",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871117351",
            "telephone_number": "505-345-6100",
            "fax_number": "505-212-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD WAVE PSYCHOTHERAPY OF NEW MEXICO",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "LITTLEWOOD",
        "authorized_official_first_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-977-7972",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.