Individual provider Active NPI

Amanda Joy Gately, MA, LMFT

  • Marriage & Family Therapist
  • Albuquerque, NM
National Provider Identifier
1205145877
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0148481 Issued in NM
Practice address
2612 Texas St NE
Albuquerque, NM 87110-4684
Phone
(505) 414-3883
NPI assigned
Sep 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T-0135011 NM
Marriage & Family Therapist 106H00000X 0148481 NM Primary

Addresses

Primary practice location

2612 Texas St NE
Albuquerque, NM 87110-4684

Mailing address

2612 Texas St NE
Albuquerque, NM 87110-4684
Phone (505) 414-3883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0148481NMMDMarriage & Family Therapist
T-0135011NMMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heirloom LLC Marriage & Family Therapist Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1205145877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 TEXAS ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104684",
            "telephone_number": "505-414-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 TEXAS ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104684",
            "telephone_number": "505-414-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATELY",
        "first_name": "AMANDA",
        "middle_name": "JOY",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "T-0135011",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "0148481",
            "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 Sep 6, 2013; 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.