Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Meditelecare of New Mexico, LLC

Organization Clinical Psychologist · NPI 1629639729

Meditelecare of New Mexico, LLC is a Clinical Psychologist in Espanola, New Mexico. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

206 S Coronado Ave
Espanola, NM 87532-2792
Phone: (860) 788-6404
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X
Clinical Psychologist Taxonomy 103TC0700X
Clinical Social Worker Taxonomy 1041C0700X
Geriatric Psychiatry Physician Taxonomy 2084P0805X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1629639729
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrea Godfrey — Credentialing & Enrollment Manager · (860) 398-6441
NPI enumeratedJune 28, 2019
Last updated in NPPESMay 5, 2025
Certification dateMay 5, 2025
Mailing addressPo Box 1595, Middletown, CT 06457-8095

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