Fundamental Therapy Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FUNDAMENTAL THERAPY SERVICES LLC

Practice address

500 Marquette Ave NW Ste 1277
Albuquerque, NM 87102-5340

Phone

(505) 353-0800

NPI assigned

Jan 9, 2024

Organization subpart

No

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

Authorized official

Name

Vanessa Rodriguez, LCSWNPI 1215454301

Title

Licensed Clinical Social Worker

Phone

(505) 353-0800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Vanessa Rodriguez, PMSW

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1215454301
  NPD Authorized official

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1548030679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 VISTA SERENA LN SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871217650",
            "telephone_number": "505-908-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARQUETTE AVE NW STE 1277",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871025340",
            "telephone_number": "505-353-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "505-353-0800",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marylou Elizabeth Funnell, CHW
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• Monica Furlong, MD

• Community/Behavioral Health Agency in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Community/Behavioral Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.