Organization Active NPI

Goff, Lundy, & Oliver, Psychological Consultants LLC

  • Clinical Psychologist
  • Albuquerque, NM
National Provider Identifier
1386283349
Registry record updated Dec 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GOFF, LUNDY, & OLIVER, PSYCHOLOGICAL CONSULTANTS LLC
Practice address
3400 Constitution Ave NE Ste C
Albuquerque, NM 87106-1243
Phone
(505) 373-3522
NPI assigned
Dec 22, 2019
Last updated
Dec 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2019

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

Authorized official

Name
Dr. Shannon Laura Lundy, PHDNPI 1477895209
Title
Partner, Clinical Neuropsychologist
Phone
(505) 373-3522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

3400 Constitution Ave NE Ste C
Albuquerque, NM 87106-1243

Mailing address

13409 Desert Hills PL NE
Albuquerque, NM 87111-3032
Phone (505) 373-3522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240621002982 NM Part B Supplier - Clinic/Group Practice 7810430568 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

3400 Constitution Ave NE
Ste C
Albuquerque, NM 87106
Phone (505) 270-4242

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1576972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576972800000",
    "number": "1386283349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13409 DESERT HILLS PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113032",
            "telephone_number": "505-373-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CONSTITUTION AVE NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871061243",
            "telephone_number": "505-373-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOFF, LUNDY, & OLIVER, PSYCHOLOGICAL CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-22",
        "last_updated": "2019-12-22",
        "certification_date": "2019-12-22",
        "status": "A",
        "authorized_official_last_name": "LUNDY",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LAURA",
        "authorized_official_title_or_position": "PARTNER, CLINICAL NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "505-373-3522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "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 Dec 22, 2019; 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.