MS. DEMETRA CHILDRESS MS
NPI 1801959432
Counselor - Professional in Albuquerque, NM

Active since December 18, 2006PECOS EnrolledAccepts Medicare Assignment
4425 JUAN TABO BLVD NE, SUITE 103, ALBUQUERQUE, NM 87111(505) 292-8908(505) 292-3109 Get Directions Write a Review

NPPES record last updated: June 15, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Demetra Childress Ms NPPES

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

MS. DEMETRA CHILDRESS MS (NPI 1801959432) is an individual professional provider in Albuquerque, New Mexico, licensed in New Mexico (0975) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1984).

NPPES Registry Identity

NPI1801959432
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. DEMETRA CHILDRESSCredential: MS
Location Address4425 JUAN TABO BLVD NE, SUITE 103Albuquerque, NM 87111-2681
Mailing Address4425 Juan Tabo Blvd Ne, Suite 103Albuquerque, NM 87111-2681 · (505) 292-8908 · Fax (505) 292-3109
Fax(505) 292-3109
Sole ProprietorYes
Medical School CMSOtherGraduated 1984
Enumeration DateDecember 18, 2006
Last NPPES UpdateJune 15, 2014
NPI 1801959432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in NM · 0975
4425 JUAN TABO BLVD NE, Albuquerque, NM 87111

Other Identifiers 3

Medicaid01357573NM
OtherNM101536NM · Value Options Salvd
Other201012073NM · Presbyterian Health Plan

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Demetra Childress Ms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810338613
PECOS Enrollment IDI20240510001472
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

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

Dietitian, Registered
4425 JUAN TABO BLVD NE
ALBUQUERQUE, NM 87111
Dietitian, Registered
4425 JUAN TABO BLVD NE, SUITE 140
ALBUQUERQUE, NM 87111

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1801959432, enumerated as an "individual" on December 18, 2006.

The provider is located at 4425 JUAN TABO BLVD NE SUITE 103 ALBUQUERQUE, NM 87111 and the phone number is (505) 292-8908.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.