KEVIN RYAN PUCKETT I


Address: 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179
Phone: 5052426919

KEVIN RYAN PUCKETT I (NPI# 1881207496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881207496
Entity Type Individual
Full Name KEVIN RYAN PUCKETT I
Credential LSAA
Practice Address 1528 Five Points Rd Sw
Albuquerque
NM 87105-3179
Mailing Address 1805 Llano Ct Nw
Albuquerque
NM 87107-2631
Practice Telephone 5052426919
Mailing Telephone 5055067595
Enumeration Date 2020-08-25
Last Update Date 2020-08-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TA0400X Psychologist
Specialization: Addiction (Substance Use Disorder)
CSA0210841 NM Behavioral Health & Social Service Providers

Office Location

Street Address 1528 FIVE POINTS RD SW
City ALBUQUERQUE
State NM
Zip Code 87105-3179

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104040088 Michael Wayne Giddings Counselor 1528 Five Points Rd Sw, Albuquerque, NM 87105-3014 2007-04-12
1467061127 Kenneth M. Wanya Counselor 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2020-07-29
1710445994 Natalie Nicotine Social Worker 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2019-03-07
1750850517 Larissa Shantaa Miller Counselor 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2018-11-21
1417458738 Richard Ibarra Social Worker 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2018-02-22
1417458746 Alexandria N Padilla Social Worker 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2018-02-22
1427559772 Theresa Ann Day Counselor 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2018-02-22
1689175911 Michel Jean Mcqueen Social Worker 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2018-02-22
1487015186 Dixie Bingham IIi Counselor 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2016-03-09
1245690031 Christi Warner Counselor 1528 Five Points Rd Sw, Albuquerque, NM 87105-3179 2016-03-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588278063 Jacob Hill Rehabilitation Practitioner 2001-b El Centro Familiar Blvd Se, Albuqerque, NM 87105 2020-09-02
1083264824 Kacie Rhodes Technician 515 Isleta Blvd Sw, Albuquerque, NM 87105 2019-09-13
1043870454 Equal LLC Assisted Living Facility 207 Lagunitas Lane, Albuquerque, NM 87105 2019-06-18
1043792997 Elizabeth Bennett Counselor 309 59th St Nw, Albuquerque, NM 87105 2018-09-06
1316439920 Deann Nieto Rehabilitation Practitioner 2001b El Centro Familiar Blvd Sw, Albuquerque, NM 87105 2018-05-31
1487163457 Karen Bejarano Behavior Technician 1847 Val Verde Rd Sw, Albuquerque, NM 87105 2017-09-21
1306360391 Bendiciones Home Health Care Home Health 5500 Cleo Rd. Sw, Albuquerque, NM 87105 2017-08-01
1578927711 Clarence Mills Counselor 1528 Five Points Rd Nw, Albuquerque, NM 87105 2016-04-13
1386024727 Rachel Elaine Kadetz Counselor 1101 Lopez Rd. Sw, Albuquerque, NM 87105 2015-06-01
1598160772 Sandra Jean Taylor Lactation Consultant, Non-RN 1305 Blake Rd Sw, Albuquerque, NM 87105 2014-10-30
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Taxonomy Information

Taxonomy Code 103TA0400X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518485812 Windsong Counseling & Consultation, LLC Psychologist 9426 Indian School Rd Ne Ste 1, Albuquerque, NM 87112-2887 2017-09-07
1558762245 Sage Addiction Treatment Services Psychologist 2929 Coors Blvd Nw Ste 100d, Albuquerque, NM 87120-1272 2014-09-12
1437346566 Thomas Paul Dominguez Psychologist 625 Truman St Ne, Albuquerque, NM 87110-6443 2007-10-02
1578632741 Anne Rose Psychologist 11005 Spain Rd Ne, Albuquerque, NM 87111-1899 2006-11-06

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326420951 Juan Mendoza Psychologist 715 E. Idaho, Las Cruces, NM 88007 2015-06-19
1265698880 Recovery Physician Group of California, LLC Psychologist 551 W Cordova Rd Ste 818, Santa Fe, NM 87505-1825 2008-08-04
1720201759 Stephen J Schoen Psychologist 1879 El Segundo Trl, Las Cruces, NM 88011-4033 2007-04-10
1043378771 Nancy Handmaker Psychologist 3949 Corrales Road, Suite 240, Corrales, NM 87048 2006-12-05
1588003123 Maria Inez Bagwell Psychologist 100 W. Griggs Ave, Las Cruces, NM 88001 2013-06-17
1740553593 Amanda R Martinez Psychologist 1615 Ojo Court, Farmington, NM 87401 2012-02-09

Competitor

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City ALBUQUERQUE
Zip Code 87105

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Dataset Information

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.

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