Terre G Coberly

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bloomfield, NM

NPI 1649849217 · NPPES record last updated Aug 9, 2024

Key facts

NPI
1649849217
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CAD0208011
Practice address
101 E Broadway Ave
Bloomfield, NM 87413-6235
Phone
(505) 330-8220
Fax
(505) 234-7867
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Angel Peak Counseling, LLC Current
since Jun 22, 2021
Accepting new patients
Sadie L Smith-McDaniel Current
since Jun 22, 2021
Accepting new patients

Locations

101 E Broadway Ave
Bloomfield, NM 87413
Phone (505) 330-8220

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NM
Addiction (Substance Use Disorder) Counselor 101YA0400X CAD0208011 Yes

Addresses

Primary practice location

101 E Broadway Ave
Bloomfield, NM 87413-6235

Mailing address

101 E Broadway Ave
Bloomfield, NM 87413-6235
Phone (505) 330-8220

Other providers in Bloomfield, NM

All providers in Bloomfield, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.