Kristine Susan Souza, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0114541 Issued in NM

Practice address

3949 Corrales Rd Ste 205
Corrales, NM 87048-9348

Phone

(505) 385-0439

NPI assigned

Mar 21, 2007

Last updated

Jun 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Mexico Counseling CenterGroup PAC ID 1759720782, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New Mexico Counseling Center

  • Community/Behavioral Health Agency
  • Corrales, NM
  • NPI 1134411259
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1386760452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 CORRALES RD STE 205",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489348",
            "telephone_number": "505-385-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 CORRALES RD STE 205",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489348",
            "telephone_number": "505-385-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "KRISTINE",
        "middle_name": "SUSAN",
        "name_prefix": "Miss",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "0114541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Therapeutic Services LLC
• Seva Pain and Wellness
• Rachel Louise Sheahan
• Lee S. Shuster, LISW, LCSW
• Mary Kathleen Slattery, MSW
• David Ellis Stinchcomb, M.D.
• C Dayne Sultrmeier Williams, OT
• Ana Sutulov Marin, CPT
• Shelby R Tarango, OT
• Thomas J. Taylor, MD, MPH

• Marriage & Family Therapist in Corrales, NM
• Providers in Corrales, NM by specialty
• Marriage & Family Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.