Women in Leadership New Mexico Inc
Organization Active NPI Cognitive & Behavioral Psychologist · Albuquerque, NM
NPI 1508633405 · NPPES record last updated Dec 21, 2023
Key facts
- NPI
- 1508633405
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cognitive & Behavioral Psychologist 103TB0200X
- Legal business name
- WOMEN IN LEADERSHIP NEW MEXICO INC
- Practice address
- 300 Central Ave SW
1500 East
Albuquerque, NM 87102 - Phone
- (505) 369-1731
- NPI assigned
- Dec 11, 2023
- Organization subpart
- No
Authorized official
- Name
- Stacy Burleson, CPSW
- Title
- Executive Director
- Phone
- (505) 322-9850
Corporate family (same tax ID) 1
Practitioners 12
-
Stacy L Burleson, CPSW
-
Daijah Marie Smith, CD, CPSW, MHFA, CHW
-
Demetre Wallace, CHW
-
Scott Foster, CHW
-
Sophia Outley, BA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251202000675 | NM | Part B Supplier - Clinic/Group Practice | 1355834128 | Practice locations: Albuquerque, NM |
National Provider Directory
- Tax ID family
- Women in Leadership
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist |
103TB0200X | Yes |
Addresses
Primary practice location
300 Central Ave SW
1500 East
Albuquerque, NM 87102
Mailing address
300 Central Ave SW
1500 East
Albuquerque, NM 87102
Phone (505) 369-1731
Other practice location 1
220 Charleston St NE Apt 220
Albuquerque, NM 87108-2168
Phone (505) 369-1731
Other names
- Women In Leadership
Other providers in Albuquerque, NM
- Yisroel Wolmark
- Heidi S Wolne
- April Wolski
- Susan Wolterstorff
- Jared W Womack
- Women in Leadership New Mexico Inc
- Women'S Cancer and Surgical Care PC
- Women'S Pelvic Specialty Care
- Women'S Pelvic Specialty Care of New Mexico, LLC
- Women'S Specialists of New Mexico
All providers in Albuquerque, NM · Cognitive & Behavioral Psychologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.