Patricia Elizabeth McKenna, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

710 Issued in NM

Practice address

1200 Eubank Blvd NE
Albuquerque, NM 87112

Phone

(505) 271-5050

Fax

(505) 271-1080

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tricia Elizabeth McKenna Other name

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

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Life Change Psychotherapy Institute, PCGroup PAC ID 6305107897, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Life Change Psychotherapy Institute, PC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1740409135
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467525345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EUBANK BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87112",
            "telephone_number": "505-271-5050",
            "fax_number": "505-271-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EUBANK BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87112",
            "telephone_number": "505-271-5050",
            "fax_number": "505-271-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "PATRICIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "MCKENNA",
            "middle_name": "ELIZABETH",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Juanita McKeller
• Katharine McKelvey
• Andrew McKenna
• Ashley Susan McKenna, LPCC
• Laura Kathryn McKenna, PA-C
• Thomas Francis McKenna Jr., PHD
• Rowan Loren McKenzie-Park, PA-S
• Diane McKenzie, SLP
• Katherine Leslie McKenzie, CNP
• Michelle Elizabeth McKenzie, M.A.

• Psychologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.