Blue Sage Counseling and Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-05493 Issued in NM

Legal business name

BLUE SAGE COUNSELING AND PSYCHOTHERAPY, LLC

Practice address

1839 Betts St NE
Albuquerque, NM 87112-3103

Phone

(505) 463-1829

NPI assigned

Sep 13, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Russell E. Adams, LISWNPI 1396894994

Title

President

Phone

(505) 463-1829

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

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

• Russell E Adams, LISW

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1396894994
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1578845962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 BETTS ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123103",
            "telephone_number": "505-463-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 BETTS ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123103",
            "telephone_number": "505-463-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SAGE COUNSELING AND PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-463-1829",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-05493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33827028",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396894994",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Horse Counseling LLC
• Blue Iris Counseling & Consulting LLC
• Blue Lotus Therapy LLC
• Blue Mesa Psychiatry and Counseling LLC
• Blue Mountain Mental Health, LLC
• Blue Skies Counseling LLC
• Blue Sky Case Management, Inc.
• Blue Sky Dental LLC
• Blue Sky Psychiatry LLC
• Blue Sky Sleep Solutions

• 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 Sep 13, 2011; 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.