Renee H Wilkins, PSY. D., MP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY0897 Issued in NM

Practice address

200 N 1St St Ste B
Grants, NM 87020-3905

Phone

(505) 290-4551

Fax

(505) 658-2398

NPI assigned

Jun 12, 2008

Last updated

Mar 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Winds of Change Mental Health Services, LLC

  • Clinical Psychologist
  • Grants, NM
  • NPI 1548677669
  Authorized official Same address or phone
• Beverly Michael

  dba Sierra Vista Counseling

  • Community/Behavioral Health Agency
  • Grants, NM
  • NPI 1295910065
  NPD (past)
• Sierra Vista Counseling, LLC

  • Community/Behavioral Health Agency
  • Grants, NM
  • NPI 1902047160
  NPD (past)

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1609036656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 178",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870200178",
            "telephone_number": "505-290-4551",
            "fax_number": "505-658-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N 1ST ST STE B",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870203905",
            "telephone_number": "505-290-4551",
            "fax_number": "505-658-2398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 E Terrace Dr",
            "address_purpose": "LOCATION",
            "city": "Grants",
            "state": "NM",
            "postal_code": "870203903",
            "country_code": "US",
            "telephone_number": "505-290-4551",
            "fax_number": "505-658-2398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "RENEE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PSY. D., MP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2023-03-30",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "PSY0897",
            "primary": true
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "PSY-RXP0034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #15607)
• Melissa L War
• Beth Marie Wengert, RN
• Tammy L. White, LMSW
• Wilma Beverly White, OTA
• Winds of Change Mental Health Services, LLC
• Rebecca Irene Woody, LPCC
• Amy Lynn Yates
• Dorcas Ann Yates, RN CFNP
• Tracy Zamora

• Clinical Psychologist in Grants, NM
• Providers in Grants, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.