Sea Change Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SEA CHANGE THERAPY LLC

Practice address

712 Valencia Dr NE
Albuquerque, NM 87108-1750

Phone

(505) 463-6740

NPI assigned

Jul 25, 2023

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

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Catherine Anne Haun, LMSW

  • Social Worker
  • Albuquerque, NM
  • NPI 1548553308
  Medicare reassignment NPD

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1518648401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 VALENCIA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 VALENCIA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081750",
            "telephone_number": "505-463-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA CHANGE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "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": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Scrimshaw
• Sara A Scripp, LMHC
• Regina Eve Scull, MSW/MBA
• Kimberly Deneen Scullion, MA
• SDLT, LLC (Clinica Simpatica)
• Sea Family Healthcare, LLC
• Brian R. Seader, O.D.
• Sandra K Sealey, PT
• Sealight Wellness LLC
• Victoria Sealy, BCBA

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.