Robert Kevin Hennelly, LPPC, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ROBERT KEVIN HENNELLY, LPPC, LLC

Practice address

2205 Miguel Chavez Rd Ste F
Santa Fe, NM 87505-1111

Phone

(505) 629-7108

NPI assigned

Jan 19, 2021

Organization subpart

No

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

Authorized official

Name

Robert K Hennelly, LPPCNPI 1942415575

Title

Psychotherapist

Phone

(505) 629-7108

Specialties & licenses 3

Addresses

Other identifiers 1

Practitioners 1

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

• Robert Hennelly, MA

  • Professional Counselor
  • Santa Fe, NM
  • NPI 1942415575
  NPD Authorized official

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1073103552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 CALLE DERECHA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056530",
            "telephone_number": "505-629-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 MIGUEL CHAVEZ RD STE F",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051111",
            "telephone_number": "505-629-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT KEVIN HENNELLY, LPPC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "HENNELLY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "505-629-7108",
        "authorized_official_credential": "LPPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25087827",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany A Robak, DO
• Eleanor Frances Robbins, MSW LISW LCSW
• Emily Robbins, CCC-SLP
• Monica Jean Robbins, LMSW
• Robert a McCormick MD LTD
• Brooke Roberts, PHD
• Carolyn Roberts, MSN, RN, APRN, BC
• Cody Roberts, CPSW
• Danielle Renee Roberts
• Howard William Roberts IV, CRNA

• Mental Health Clinic/Center (Including Community Mental Health Center) in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.