Provider Demographics
NPI:1447583935
Name:WADE-BECHER, CHRISTINE ALETHEA (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ALETHEA
Last Name:WADE-BECHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14837
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87191-4837
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:505-220-3643
Practice Address - Street 1:2901 JUAN TABO BLVD NE STE E&F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1886
Practice Address - Country:US
Practice Address - Phone:505-220-3643
Practice Address - Fax:855-764-7379
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-079711041C0700X
NMC-079711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM64633349Medicaid