NPIMap

Organization Active NPI

Sage Addiction Treatment Services

  • Addiction (Substance Use Disorder) Psychologist
  • Albuquerque, NM
National Provider Identifier
1558762245
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
License
0930 Issued in NM
Legal business name
SAGE ADDICTION TREATMENT SERVICES
Practice address
2929 Coors Blvd NW Ste 100D
Albuquerque, NM 87120-1272
Phone
(505) 977-9180
NPI assigned
Sep 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Authorized official

Name
Dr. Mark S Simpson, CLINICAL PSYCHOLOGISNPI 1518952662
Title
Director/Clinical Psychologist
Phone
(505) 977-9180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X 0930 NM Primary

Addresses

Primary practice location

2929 Coors Blvd NW Ste 100D
Albuquerque, NM 87120-1272

Mailing address

2929 Coors Blvd NW Ste 100D
Albuquerque, NM 87120-1272
Phone (505) 977-9180

Other identifiers 1

IdentifierTypeStateIssuer
1518952662MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Mark Simpson PSYD Mac Ladac3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2929 Coors Blvd NW
Ste 100D
Albuquerque, NM 87120
Phone (505) 977-9180

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410480000000",
    "number": "1558762245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 COORS BLVD NW STE 100D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201272",
            "telephone_number": "505-977-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 COORS BLVD NW STE 100D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201272",
            "telephone_number": "505-977-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE ADDICTION TREATMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-12",
        "last_updated": "2014-09-12",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "505-977-9180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CLINICAL PSYCHOLOGIS"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518952662",
            "state": "NM"
        }
    ],
    "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 Sep 12, 2014; 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.