Individual provider Active NPI

Rachel Coleman, PH.D.

  • Psychologist
  • Albuquerque, NM
National Provider Identifier
1487061610
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1336 Issued in NM
Practice address
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone
(505) 265-1711
NPI assigned
Jul 21, 2014
Last updated
Jul 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1336 NM Primary

Addresses

Primary practice location

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153

Mailing address

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone (505) 265-1711

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220712003651 NM Practitioner - Clinical Psychologist 2264813963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
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)

1200 Eubank Blvd NE
Albuquerque, NM 87112-5314
Phone (505) 271-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1336NMMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Change Psychotherapy Institute, PC CurrentSince Jul 1, 2022 Accepting new patients

Locations

1200 Eubank Blvd NE
Albuquerque, NM 87112
Phone (505) 271-5050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1487061610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-265-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-265-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "RACHEL",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "1336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.