Organization Active NPI

Harmony Haven Psychiatric LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1316779598
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HARMONY HAVEN PSYCHIATRIC LLC
Practice address
612 1St St NW
Albuquerque, NM 87102-2306
Phone
(954) 451-8444
NPI assigned
Aug 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Mrs. Lovette Agatha Agbomma Ndubisi, NP
Title
Pmhnp-BC/Provider
Phone
(954) 451-8444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

612 1St St NW
Albuquerque, NM 87102-2306

Mailing address

10232 Country Sage Dr NW # Abq
Albuquerque, NM 87114-3515
Phone (109) 544-5184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250225002921 NM Part B Supplier - Clinic/Group Practice 5799205407 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM
O20260611003637 AZ Part B Supplier - Clinic/Group Practice 5799205407 Receives reassigned benefits from 1 practitioner
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

612 1st St NW
Albuquerque, NM 87102
Phone (954) 451-8444

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": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1316779598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10232 COUNTRY SAGE DR NW # ABQ",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143515",
            "telephone_number": "109-544-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 1ST ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022306",
            "telephone_number": "954-451-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARMONY HAVEN PSYCHIATRIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "NDUBISI",
        "authorized_official_first_name": "LOVETTE AGATHA",
        "authorized_official_middle_name": "AGBOMMA",
        "authorized_official_title_or_position": "PMHNP-BC/PROVIDER",
        "authorized_official_telephone_number": "954-451-8444",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "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 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.