JOHN LAWRENCE VAN DYKE SR. (NPI# 1083788822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083788822 |
| Entity Type | Individual |
| Full Name | JOHN LAWRENCE VAN DYKE SR. |
| Credential | PH.D. |
| Practice Address |
546 Harkle Rd Santa Fe NM 87505-4784 |
| Practice Telephone | 5059829360 |
| Practice Fax Number | 5059881480 |
| Mailing Telephone | 5059829360 |
| Mailing Fax Number | 5059881480 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
4963 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
700 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CIGNA BEHAVIORAL HEALTH | 99425 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487151536 | John Chandler Van Dyke | Student in an Organized Health Care Education/Training Program | 2003 Tulane Avenue, New Orleans, LA 70112 | 2018-04-06 |
| Street Address |
546 HARKLE RD |
| City | SANTA FE |
| State | NM |
| Zip Code | 87505-4784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598759938 | Shanti Elke Bannwart | Counselor | 546 Harkle Rd, Ste C, Santa Fe, NM 87505-4784 | 2005-08-31 |
| 1992230841 | Beth R. Reich M.d. LLC | Clinic/Center | 546 Harkle Rd, Suite B, Santa Fe, NM 87505-4784 | 2017-04-28 |
| 1275986457 | Journey Well | Clinic/Center | 546 Harkle Rd, Santa Fe, NM 87505-4784 | 2016-07-22 |
| 1740672971 | Marilyn L Matthews Md | Psychiatry & Neurology | 546 Harkle Rd, Suite B, Santa Fe, NM 87505-4784 | 2015-02-25 |
| 1104226513 | Christopher Johnson | Counselor | 546 Harkle Rd, Suite B, Santa Fe, NM 87505-4784 | 2014-09-04 |
| 1265879712 | Enchanted Care Services Inc. | Hospice Care, Community Based | 546 Harkle Rd, Suite B, Santa Fe, NM 87505-4784 | 2013-05-23 |
| 1760705933 | Susan Balkman | Counselor | 546 Harkle Rd, Santa Fe, NM 87505-4784 | 2010-03-02 |
| 1043461783 | Betsy G Sultan | Massage Therapist | 546 Harkle Rd, Suite B, Santa Fe, NM 87505 | 2008-09-30 |
| 1548477615 | Gregory Alan Mapes | Counselor | 546 Harkle Rd, Ste C, Santa Fe, NM 87505 | 2007-05-17 |
| 1700093499 | Kathryn L Rominger | Social Worker | 546 Harkle Rd, Ste C, Santa Fe, NM 87505 | 2007-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154939031 | Enchanted Sky Hospice,llc | Hospice Care, Community Based | 1692b Hospital Drive, Vigil Office Building, Suite 201a, Santa Fe, NM 87505 | 2020-07-16 |
| 1700409968 | Caa Consulting, LLC | Clinic/Center | 1448 S St. Francis Drive, Santa Fe, NM 87505 | 2020-05-22 |
| 1104447093 | Dana Marie Tsyconyea Simmons | Counselor | 1640 Calle Medico, Suite E, Santa Fe, NM 87505 | 2020-05-01 |
| 1114574217 | Kumara Hampton Therapy, LLC | Counselor | 11 Calle Medico Suite 4, Santa Fe, NM 87505 | 2019-08-22 |
| 1245886977 | Caroline Ward | Technician | 513 Velarde St 513 Velarde St, Santa Fe, NM 87505 | 2019-08-19 |
| 1205490752 | Alyson Yacono | Physical Therapist | 104 Old Las Vegas Highway, Santa Fe, NM 87505 | 2019-04-30 |
| 1366919649 | Allyson Matthews | Speech-Language Pathologist | Santa Fe Public Schools Special Education Department, 1300 Camino Sierra Vista, Santa Fe, NM 87505 | 2018-10-25 |
| 1093280281 | Diamond Care Santa Fe LLC | Skilled Nursing Facility | 635 Harkle Road, Santa Fe, NM 87505 | 2018-10-04 |
| 1972087054 | Changing Woman Initiative | Advanced Practice Midwife | 460 Saint Michaels Drive, Suite 804, Santa Fe, NM 87505 | 2018-09-24 |
| 1154812782 | Heart Wing, LLC | Social Worker | 2724 Alamosa Drive, Santa Fe, NM 87505 | 2018-05-18 |
| Find all providers in zip 87505 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487014957 | Soul Healing Center | Psychologist | 404 Brunn School Rd Ste C, Santa Fe, NM 87505-1102 | 2016-02-26 |
| 1053700344 | William Douglas Frost | Psychologist | 560 E Coronado Rd, Santa Fe, NM 87505-0347 | 2015-01-09 |
| 1861892465 | Tahlia Rainbolt | Psychologist | 1012 Marquez Pl # 211, Santa Fe, NM 87505-1834 | 2014-09-02 |
| 1487910402 | Northern New Mexico Neuropsychology LLC | Psychologist | 1911 5th St Ste 211, Santa Fe, NM 87505-5403 | 2012-04-03 |
| 1619253119 | Barry Fields | Psychologist | 62 Avenida Aldea, Santa Fe, NM 87507-9449 | 2011-10-27 |
| 1053632851 | Southwest Cares Nv LLC | Psychologist | 119 East Marcy St., Suite 202, Santa Fe, NM 87501-2046 | 2010-06-15 |
| 1255585154 | Joseph Glenn Ferguson | Psychologist | 2232 Wilderness Arroyo, Santa Fe, NM 87505-5922 | 2008-11-05 |
| 1457548075 | Melissa Maxwell Davis | Psychologist | 552 Agua Fria St, Santa Fe, NM 87501-2508 | 2007-09-27 |
| 1841494598 | Alice Kahle | Psychologist | 811 Saint Michaels Dr, Suite 105, Santa Fe, NM 87505-7641 | 2007-06-14 |
| 1336341247 | Rebecca Roddey Holt | Psychologist | 3240 La Avenida De San Marcos, Santa Fe, NM 87507-0451 | 2007-06-03 |
| Find all providers in SANTA FE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.