NPIMap

Organization Active NPI

Umoja Behavioral Health PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Albuquerque, NM
National Provider Identifier
1063989648
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
UMOJA BEHAVIORAL HEALTH PC
Practice address
3150 Carlisle Blvd NE Ste 110
Albuquerque, NM 87110-1681
Phone
(505) 672-5598
Fax
(505) 214-5071
NPI assigned
Nov 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenneth B Winfrey, LMSWNPI 1649500554
Title
Owner
Phone
(505) 663-6645

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

3150 Carlisle Blvd NE Ste 110
Albuquerque, NM 87110-1681

Mailing address

3150 Carlisle Blvd NE Ste 105
Albuquerque, NM 87110-1680
Phone (505) 663-8173

Other practice location 1

3150 Carlisle Blvd NE Ste 105
Albuquerque, NM 87110-1680
Phone (505) 663-8173 ext. 125

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address info@umojawellness.com Direct
Direct Messaging Address info@umojawellness.com Direct
Direct Messaging Address info@umojawellness.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190409001718 NM Part B Supplier - Clinic/Group Practice 9537400148 Receives reassigned benefits from 4 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

3150 Carlisle Blvd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 633-8173

2741 Indian School Rd NE
Ste 103
Albuquerque, NM 87106
Phone (505) 252-2185

Practitioners & affiliated clinicians

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 59

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1063989648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 CARLISLE BLVD NE STE 105",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101680",
            "telephone_number": "505-663-8173",
            "fax_number": "505-672-7769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CARLISLE BLVD NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101681",
            "telephone_number": "505-672-5598",
            "fax_number": "505-214-5071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3150 Carlisle Blvd NE Ste 105",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871101680",
            "country_code": "US",
            "telephone_number": "505-663-8173 x125",
            "fax_number": "505-214-5071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UMOJA BEHAVIORAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-01",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "WINFREY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-663-6645",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@umojawellness.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3150 Carlisle Blvd NE Ste 105",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871101680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@umojawellness.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3150 Carlisle Blvd NE Ste 105",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871101680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@umojawellness.com",
            "affiliation": "N",
            "endpointDescription": "agency mailbox",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3150 Carlisle Blvd NE Ste 105",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871101680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.