MEDITELECARE OF NEW MEXICO, LLC
NPI 1629639729
Psychiatry & Neurology - Psychiatry in Espanola, NM

Q: What is Meditelecare Of New Mexico, LLC's NPI number?

The NPI number for Meditelecare Of New Mexico, LLC is 1629639729. It was assigned to this organization in the NPPES registry on June 28, 2019.

Q: What is Meditelecare Of New Mexico, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Active since June 28, 2019

206 S CORONADO AVE, ESPANOLA, NM 87532(860) 788-6404 Get Directions Write a Review

NPPES record last updated: May 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 5, 2025, Sep 4, 2024 (2 updates tracked since 2024).

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About Meditelecare Of New Mexico, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDITELECARE OF NEW MEXICO, LLC (NPI 1629639729) is a healthcare organization registered as a psychiatry in Espanola, New Mexico and active in the NPI registry since June 2019. The organization lists Andrea Godfrey, Credentialing & Enrollment Manager, as its authorized official.

NPPES Registry Identity

NPI1629639729

Entity TypeOrganization

Primary Taxonomy2084P0800X

Legal Business NameMEDITELECARE OF NEW MEXICO, LLC

Location Address206 S CORONADO AVEEspanola, NM 87532-2792

Mailing AddressPo Box 1595Middletown, CT 06457-8095 · (860) 788-6404 · Fax (860) 829-0495

Phone(860) 788-6404

Organization SubpartNo

Authorized OfficialAndrea GodfreyCredentialing & Enrollment Manager · (860) 398-6441

Enumeration DateJune 28, 2019

Last NPPES UpdateMay 5, 20252 updates tracked since enumeration

NPPES CertifiedMay 5, 2025

✔ NPI 1629639729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedPsychiatry & Neurology · Geriatric PsychiatryTaxonomy 2084P0805X

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X

206 S CORONADO AVE, Espanola, NM 87532

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KEITH BRYAN HAYNIE DNP, RN, CFNP

Nurse Practitioner (Psychiatric/Mental Health)