Individual provider Active NPI

Kathryn Sandoval

  • Marriage & Family Therapist
  • Rio Rancho, NM
National Provider Identifier
1336550466
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1401 Soave Dr SE
Rio Rancho, NM 87124-8849
Phone
(505) 490-1998
NPI assigned
May 12, 2014
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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 NU Primary

Addresses

Primary practice location

1401 Soave Dr SE
Rio Rancho, NM 87124-8849

Mailing address

1401 Soave Dr SE
Rio Rancho, NM 87124-8849
Phone (505) 490-1998

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
I20240801004560 NM Practitioner - Mental Health Counselor 3072050517 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Haven Behavioral Health LLC CurrentSince Oct 1, 2024 Accepting new patients
Lavender Roots Therapeutic Services Marriage & Family Therapist CurrentSince Jul 20, 2024 Accepting new patients

Locations

1380 Rio Rancho Blvd SE
Rio Rancho, NM 87124
Phone (505) 916-4729

Organizations & group practices 2

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": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1336550466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SOAVE DR SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871248849",
            "telephone_number": "505-490-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SOAVE DR SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871248849",
            "telephone_number": "505-490-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.