Provider Demographics
NPI:1194129577
Name:DR HELEN MARIE PEARCE ED D LLC
Entity type:Organization
Organization Name:DR HELEN MARIE PEARCE ED D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:ED D
Authorized Official - Phone:505-715-2459
Mailing Address - Street 1:7900 WOODWIND DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5259
Mailing Address - Country:US
Mailing Address - Phone:505-715-2459
Mailing Address - Fax:505-797-7628
Practice Address - Street 1:100 SUN AVE NE
Practice Address - Street 2:SUITE 650
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4659
Practice Address - Country:US
Practice Address - Phone:505-715-2459
Practice Address - Fax:505-797-7628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM438103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN6684Medicaid
NMNMB2201Medicare PIN