NEUROPSYCHOLOGICAL SERVICES OF NEW MEXICO, LLC (NPI# 1326115049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326115049 |
| Entity Type | Organization |
| Organization Name | NEUROPSYCHOLOGICAL SERVICES OF NEW MEXICO, LLC |
| Practice Address |
4001 Indian School Rd Ne Ste 310 Albuquerque NM 87110-3832 |
| Practice Telephone | 5054049395 |
| Practice Fax Number | 5052994740 |
| Mailing Telephone | 5054049395 |
| Mailing Fax Number | 5052994740 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2019-10-10 |
| Authorized Official Name | DR. JOHN HAROLD KING (DIRECTOR) |
| Authorized Official Telephone | 5054049395 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | 0969 | NM | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
0969 | NM | Behavioral Health & Social Service Providers |
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
Behavioral Health & Social Service Providers |
| Street Address |
4001 INDIAN SCHOOL RD NE STE 310 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-3832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811977325 | John King | Clinical Neuropsychologist | 4001 Indian School Rd Ne Ste 310, Albuquerque, NM 87110-3832 | 2006-01-19 |
| 1447895651 | Albuquerque Neuropsychology LLC | Clinic/Center | 4001 Indian School Rd Ne Ste 310, Albuquerque, NM 87110-3832 | 2019-11-12 |
| 1730534587 | Summer Rolin | Clinical Neuropsychologist | 4001 Indian School Rd Ne Ste 310, Albuquerque, NM 87110-3832 | 2016-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003218553 | Integrated Healthcare of New Mexico | Psychologist | 7632 William Moyers Ave Ne, Albuquerque, NM 87122-2765 | 2014-09-16 |
| 1245856913 | Paul King-miller Psyd Lpcc LLC | Psychologist | 11216 Brentwood Hills Blvd Ne, Albuquerque, NM 87112-3219 | 2020-06-18 |
| 1477585990 | Deborah Leslie Kos | Psychologist | 4810 Hardware Dr Ne, Albuquerque, NM 87109-2013 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417489378 | Primary Wellness Team Corporation | Psychologist | 5805 Mcnutt Rd, Ste D, Santa Teresa, NM 88008-8001 | 2017-03-30 |
| 1154877371 | J. Michael Mash Prescribing Psychologist LLC | Psychologist | 4155 State Road 68, Unit 6, Rancho De Taos, NM 87557 | 2016-08-28 |
| 1124466446 | Shekinah Foundation | Psychologist | 3001 S Wyoming Ave, Roswell, NM 88203-2326 | 2013-06-08 |
| 1902197098 | S M Cobb | Psychologist | 400 N Pennsylvania Ave Ste 990, Roswell, NM 88201-4754 | 2011-04-25 |
| 1730203860 | Pattijo N Velasquez | Psychologist | 1505 S Don Roser Dr, Ste. A, Las Cruces, NM 88011-4596 | 2007-03-16 |
| 1285232397 | Dr Tony J Kreuch LLC | Psychologist | 2204 Brothers Rd Ste B, Santa Fe, NM 87505-6975 | 2020-10-12 |
| 1548677669 | Winds of Change Mental Health Services, LLC | Psychologist | 108 E High St, Grants, NM 87020-2453 | 2014-07-21 |
| 1982024105 | Drw Behavioral Health Services, LLC | Psychologist | 1395 Missouri Ave, Las Cruces, NM 88001-5327 | 2014-04-27 |
| City | ALBUQUERQUE |
| Zip Code | 87110 |
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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.