Kimberly Pine Dougharty, LPAT

Primary specialty

Art TherapistTaxonomy code 221700000X

License

CTB20230922 Issued in NM

Practice address

4730 Beckner Rd
Santa Fe, NM 87507-3691

Phone

(505) 989-4500

Fax

(505) 443-8313

NPI assigned

Nov 7, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1487428843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 VELARDE RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875075126",
            "telephone_number": "253-720-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 BECKNER RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875073691",
            "telephone_number": "505-989-4500",
            "fax_number": "505-443-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHARTY",
        "first_name": "KIMBERLY",
        "middle_name": "PINE",
        "credential": "LPAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NM",
            "license": "CTB20230922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Bernard Donovan, PH.D
• Cornelius Dooley, MD
• Kathryn M Doster, DO
• Caleb Dotson I, LMHC
• Double Rainbow & Lightning
• Nina Dougherty
• Alyiah Doughty, D.O.M., L.M.T.
• Douglas Tozzoli, DPM, PC
• Eleanore S Douglas, LPCC
• Ben Douglass

• Art Therapist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Art Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.