Kathryn Harrell
Individual provider Active NPI Speech-Language Pathologist · Santa Fe, NM
NPI 1003409285 · NPPES record last updated Mar 12, 2025
Key facts
- NPI
- 1003409285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SAH-2024-0321 (NM)
- Practice address
- 1800 Old Pecos TRL
Santa Fe, NM 87505-4759 - Phone
- (505) 424-8777
- NPI assigned
- Feb 18, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250421001390 | NM | Practitioner - Qualified Speech Language Pathologist | 0143745315 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SAH-2024-0321 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Espanola Sports Medicine, PA | Current |
Accepting new patients | |
| Hendricks Functional Health, LLC | Speech-Language Pathologist | Past | Accepting new patients |
| Eastern New Mexico University | Speech-Language Pathologist | Past |
Accepting new patients |
Locations
708 La Joya St
Espanola, NM 87532
Phone (505) 753-6550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Speech-Language Pathologist | 235Z00000X | SAH-2024-0321 | NM | Yes |
Addresses
Primary practice location
1800 Old Pecos TRL
Santa Fe, NM 87505-4759
Mailing address
1800 Old Pecos TRL
Santa Fe, NM 87505-4759
Other providers in Santa Fe, NM
- Caitlin M Harper
- Divara Harper
- Erin Harper
- Melissa Harper
- Brianna Harrand
- Adriene Harrelson
- Rachel Harrington Vierra
- Cole Daniel Harris
- Deborah Ann Harris
- Gary D Harris
All providers in Santa Fe, NM · Speech-Language Pathologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.