Rio Grande Emdr Therapy, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RIO GRANDE EMDR THERAPY, LLC

Practice address

2900 Louisiana Blvd NE Ste 210
Albuquerque, NM 87110-3569

Phone

(505) 304-9431

NPI assigned

Oct 15, 2020

Organization subpart

No

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

Authorized official

Name

Sarah Penn, LPCCNPI 1144658204

Title

Owner

Phone

(505) 304-9431

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 4

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

• Summer Clevenger, LMHC CTB-2023-0302

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1912614785
  Medicare reassignment Care Compare group NPD
• Linda Cochrum, LPCC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1245656115
  Medicare reassignment Care Compare group NPD
• Sarah Penn, LPCC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1144658204
  Medicare reassignment NPD Authorized official
• Janalee Barnard, LMHC, NCC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1427530179
  Medicare reassignment

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1861090342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LOUISIANA BLVD NE STE 210",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103569",
            "telephone_number": "505-304-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LOUISIANA BLVD NE STE 210",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103569",
            "telephone_number": "505-304-9431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Sierra Vista Drive",
            "address_purpose": "LOCATION",
            "city": "Cedar Crest",
            "state": "NM",
            "postal_code": "87008",
            "country_code": "US",
            "telephone_number": "505-304-9431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIO GRANDE EMDR THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "PENN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-304-9431",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rio Grande Body Works, LLC
• Rio Grande Chiropractic
• Rio Grande Counseling
• Rio Grande Counseling & Guidance Services, PA
• Rio Grande Dermatology, PC
• Rio Grande FS, LLC
• Rio Grande Geriatrics and Family Practice LLC
• Rio Grande Hospice LLC
• Rio Grande Internal Medicine PC
• Rio Grande Mental Health PLLC

• 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 Apr 12, 2021; 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.