Organization · Type 2 NPI

Telemental Health Link LLC

Psychiatric/Mental Health Nurse Practitioner · Albuquerque, NM

NPI number 1972367290 Active

Practice location

5700 Harper Dr NE Ste 210-4
Albuquerque, NM 87109-3573

Call (208) 775-7418 Map

Fax (208) 768-4500

Mailing address

4055 E Blueberry St
Meridian, ID 83642-8261

Other practice locations

4055 E Blueberry St, Meridian, ID 83642-8261 · (208) 600-2060

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center	261QM1300X	None listed
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	None listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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NPI record

NPI: 1972367290
Entity type: Organization (Type 2)
Issued: Feb 7, 2024
Last updated: Feb 7, 2024
Status: Active
Subpart: Yes of Telemental Health Link LLC

Other names

<unavail>
Telemental Health Link -Nm · doing business as
THL New Mexico · doing business as
Telemental Health Link New Mexico · doing business as

Authorized official

Susan M Derivas, PMHNP-BC
Ao
(208) 775-7418

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1972367290

Telemental Health Link LLC's National Provider Identifier is 1972367290, issued on Feb 7, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Albuquerque, NM. The record was last updated on Feb 7, 2024.