NPIMap

Organization Active NPI

Hillside Community Church

  • Counselor
  • Albuquerque, NM
National Provider Identifier
1164634374
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
HILLSIDE COMMUNITY CHURCH
Practice address
435 Jefferson SE
Albuquerque, NM 87108
Phone
(505) 254-2606
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Susan Correu Nettle, MD MINISTER
Title
Associate Minister Counseling Prog
Phone
(505) 254-2606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

435 Jefferson SE
Albuquerque, NM 87108

Mailing address

435 Jefferson SE
Albuquerque, NM 87108
Phone (505) 254-2606

National Provider Directory

National Provider Directory

Locations

435 Jefferson St SE
Albuquerque, NM 87108
Phone (505) 254-2606

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164634374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 JEFFERSON SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87108",
            "telephone_number": "505-254-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 JEFFERSON SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87108",
            "telephone_number": "505-254-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE COMMUNITY CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NETTLE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "CORREU",
        "authorized_official_title_or_position": "ASSOCIATE MINISTER COUNSELING PROG",
        "authorized_official_telephone_number": "505-254-2606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD MINISTER"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Aug 22, 2020; 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.