Provider Demographics
NPI:1063862241
Name:CLINICAL ASSESSMENT GROUP, LLC
Entity type:Organization
Organization Name:CLINICAL ASSESSMENT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LAVAIL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:505-705-1701
Mailing Address - Street 1:6801 JEFFERSON ST NE STE 301
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4379
Mailing Address - Country:US
Mailing Address - Phone:505-705-1701
Mailing Address - Fax:505-212-1253
Practice Address - Street 1:6801 JEFFERSON ST NE STE 301
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4379
Practice Address - Country:US
Practice Address - Phone:505-705-1701
Practice Address - Fax:505-212-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0140161251S00000X
363L00000X, 363LW0102X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty