Shawna Avila Kibuta, MS, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CTL0202841 Issued in NM

Practice address

8205 Spain Rd NE Ste 106
Albuquerque, NM 87109-3155

Phone

(505) 856-0300

Fax

(505) 856-7946

NPI assigned

Jun 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Shawna Stigge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1235588674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 SPAIN RD NE STE 106",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093155",
            "telephone_number": "505-856-0300",
            "fax_number": "505-856-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8205 SPAIN RD NE STE 106",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093155",
            "telephone_number": "505-856-0300",
            "fax_number": "505-856-7946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 3rd St NW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871021403",
            "country_code": "US",
            "telephone_number": "505-764-8231 x205",
            "fax_number": "505-248-1351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIBUTA",
        "first_name": "SHAWNA",
        "middle_name": "AVILA",
        "name_prefix": "Ms.",
        "credential": "MS, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTL0202841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N3938",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "STIGGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.