Provider Demographics
NPI:1528813508
Name:BEST SELF THERAPY LLC
Entity type:Organization
Organization Name:BEST SELF THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ROUCKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-363-3313
Mailing Address - Street 1:2201 MENAUL BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1711
Mailing Address - Country:US
Mailing Address - Phone:917-854-6331
Mailing Address - Fax:
Practice Address - Street 1:2201 MENAUL BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1711
Practice Address - Country:US
Practice Address - Phone:917-854-6331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty