NPIMap

Organization Active NPI

Edoe LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Santa Fe, NM
National Provider Identifier
1669978391
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
C-09941 Issued in NM
Legal business name
EDOE LLC
Practice address
518 Old Santa Fe TRL Ste 1
Santa Fe, NM 87505-0398
Phone
(505) 473-6191
Fax
(505) 819-1492
NPI assigned
Apr 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Authorized official

Name
Erin Sibley Doerwald, LCSWNPI 1982109062
Title
Provider
Phone
(505) 473-6191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X C-09941 NM Primary

Addresses

Primary practice location

518 Old Santa Fe TRL Ste 1
Santa Fe, NM 87505-0398

Mailing address

7430 Old Santa Fe TRL
Santa Fe, NM 87505-4574
Phone (505) 473-6191

Other identifiers 1

IdentifierTypeStateIssuer
2837987OtherNMSCC#

Other names 1

  • Hello Wellness Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1669978391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7430 OLD SANTA FE TRL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054574",
            "telephone_number": "505-473-6191",
            "fax_number": "505-983-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 OLD SANTA FE TRL STE 1",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875050398",
            "telephone_number": "505-473-6191",
            "fax_number": "505-819-1492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDOE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "DOERWALD",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "SIBLEY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "505-473-6191",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NM",
            "license": "C-09941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCC#",
            "identifier": "2837987",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hello Wellness Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hello Wellness Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; 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.