Individual provider Active NPI

Melanie Jean Porter-Kunz, LISW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1609273713
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I07190 Issued in NM
Practice address
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone
(505) 265-1711
Fax
(505) 256-5416
NPI assigned
Dec 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I07190 NM Primary
Clinical Social Worker 1041C0700X 00991456 CO

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
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00991456COMDClinical Social Worker
I07190NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1609273713",
    "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",
            "fax_number": "505-256-5416"
        },
        {
            "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",
            "fax_number": "505-256-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER-KUNZ",
        "first_name": "MELANIE",
        "middle_name": "JEAN",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-04",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I07190",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "00991456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.