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).
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 |
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 |
Street Address |
1528 FIVE POINTS RD SW |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87105-3179 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 87105 |
Taxonomy Code | 103TA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
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 |
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 |
City | ALBUQUERQUE |
Zip Code | 87105 |
Please comment or provide details below to improve the information on KEVIN RYAN PUCKETT I.
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.