Kerri Wormwood, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1129 Issued in NM

Legal business name

KERRI WORMWOOD, LLC

Practice address

3200 Carlisle NE, Suite 204
Albuquerque, NM 87110

Phone

(505) 604-1222

Fax

(505) 889-4598

NPI assigned

Mar 3, 2016

Organization subpart

No

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

Authorized official

Name

Kerri Faith Wormwood, LPCC, LPAT

Title

Clinical Counselor and Art Therapis

Phone

(505) 604-1222

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1336509348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 CARLISLE NE, SUITE 204",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-604-1222",
            "fax_number": "505-889-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CARLISLE NE, SUITE 204",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-604-1222",
            "fax_number": "505-889-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRI WORMWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "WORMWOOD",
        "authorized_official_first_name": "KERRI",
        "authorized_official_middle_name": "FAITH",
        "authorized_official_title_or_position": "CLINICAL COUNSELOR AND ART THERAPIS",
        "authorized_official_telephone_number": "505-604-1222",
        "authorized_official_credential": "LPCC, LPAT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "1129",
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": "NM",
            "license": "1128",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000A1775",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy L. Kerr, MD
• Olivia Luxanna Mariah Kerr, RBT
• Ryan Kerr
• Stephen John Kerr, PT
• Valerie Kerr
• Colleen Blanchard Kerrigan, M.D.
• Morgan Lynn Kerschen, PT, DPT
• Robert Charles Kerschen, DMD
• Jeremy Richard Kersey, PA-C
• Brian Christopher Kersh, PH.D.

• Professional Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.