Individual provider Active NPI

Sharon Lynn McKibbin, LMFT

  • Marriage & Family Therapist
  • Albuquerque, NM
National Provider Identifier
1245807817
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
CTB-2024-0433 Issued in NM
Practice address
4273 Montgomery Blvd NE Ste K220
Albuquerque, NM 87109-6748
Phone
(505) 554-1283
NPI assigned
Jun 10, 2021
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X CTB-2024-0433 NM Primary

Addresses

Primary practice location

4273 Montgomery Blvd NE Ste K220
Albuquerque, NM 87109-6748

Mailing address

4273 Montgomery Blvd NE Ste K220
Albuquerque, NM 87109-6748
Phone (505) 554-1283

Other practice location 1

848 Hunters Glen Trl
Fort Worth, TX 76120-2860
Phone (817) 602-4393

Other identifiers 1

IdentifierTypeStateIssuer
51852373MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260417002472 NM Practitioner - Marriage and Family Therapist 6002382900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace Therapy Services LLCGroup PAC ID 8820441371, 5 clinicians

Practice addresses (Care Compare)

4273 Montgomery Blvd NE
Suite K220
Albuquerque, NM 87109-6735
Phone (505) 554-1283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CTB-2024-0433NMMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Therapy Services, LLC Marriage & Family Therapist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1245807817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4273 MONTGOMERY BLVD NE STE K220",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096748",
            "telephone_number": "505-554-1283",
            "fax_number": "505-207-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4273 MONTGOMERY BLVD NE STE K220",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096748",
            "telephone_number": "505-554-1283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "848 Hunters Glen Trl",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761202860",
            "country_code": "US",
            "telephone_number": "817-602-4393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKIBBIN",
        "first_name": "SHARON",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "CTB-2024-0433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51852373",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.