Susan'S Legacy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

251B00000X Issued in NM

Legal business name

SUSAN'S LEGACY

Practice address

8100 Mountain Rd NE
Suite 200
Albuquerque, NM 87110

Phone

(505) 843-8450

Fax

(505) 840-8449

NPI assigned

Sep 16, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kathryn Weil, PHD

Title

Executive Director

Phone

(505) 843-8450

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Tax ID family

Susan'S Legacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Susan'S Legacy

  • Case Management Agency
  • Albuquerque, NM
  • NPI 1245544493
  NPD tax ID
• Susan'S Legacy

  • Case Management Agency
  • Albuquerque, NM
  • NPI 1366631780
  NPD tax ID
• Susan'S Legacy

  • Case Management Agency
  • Albuquerque, NM
  • NPI 1477797694
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carolina Ortega, MA, LPCC, NCC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1316399074
  Medicare reassignment
• Jaineen Burkettsims

  • Case Manager/Care Coordinator
  • Albuquerque, NM
  • NPI 1346882909
  NPD

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1447583836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11005 SPAIN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87111",
            "telephone_number": "503-843-8450",
            "fax_number": "505-843-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 MOUNTAIN RD NE",
            "address_2": "SUITE 200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-843-8450",
            "fax_number": "505-840-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN'S LEGACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-843-8450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": "251B00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NM600724",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Brandt Graham, MD, PHD, PC
• Susan Luna, LPCC LLC
• Susan P. Kaspi, PH.D., LLC
• Susan'S Legacy
• Susan'S Legacy
• Susan'S Legacy
• Brenda N Susman, LMFT
• Cary C Suter
• Ginevra Clare Sutherland Sanchez, LMHC
• Autumn Sutherland

• Community/Behavioral Health Agency in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Community/Behavioral Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.