Cedar Creek Behavioral Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CEDAR CREEK BEHAVIORAL HEALTH

Practice address

708 Mechem Dr Ste B
Ruidoso, NM 88345-6952

Phone

(505) 273-0982

Fax

(575) 454-3152

NPI assigned

May 2, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Ward, LCSW

Title

President

Phone

(505) 273-0982

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1447007901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 MECHEM DR STE B",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456952",
            "telephone_number": "505-273-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 MECHEM DR STE B",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456952",
            "telephone_number": "505-273-0982",
            "fax_number": "575-454-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREEK BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-273-0982",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Shantell Candelaria
• Katosha Latoya Candelaria
• Samuel Carley, MD
• Kateri Marie Carpenter, CSW
• Isreal Castello, BMS
• Center of Protective Environment, Inc.
• Sara Leslie Chapman, LSAA
• Angela Louise Chavez, PTA
• Jackie Chavez
• Jaden N Chavez

• Clinical Social Worker in Ruidoso, NM
• Providers in Ruidoso, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.