Active NPI
Heather Tkaczyk
- Community Health Worker
- Albuquerque, NM
National Provider Identifier
1609760115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 6612 Gulton CT NE Ste B
Albuquerque, NM 87109-4407 - Phone
- (505) 633-7886
- Fax
- (505) 521-5165
- NPI assigned
- Jun 7, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NM | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | NM | ||
| Community Health Worker | 172V00000X | NM | Primary | |
| Clinical Social Worker | 1041C0700X | NM |
Addresses
Primary practice location
6612 Gulton CT NE Ste B
Albuquerque, NM 87109-4407
Mailing address
6612 Gulton CT NE Ste B
Albuquerque, NM 87109-4407
Phone (505) 633-7886
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandia Therapy and Wellness Center | Clinical | Current | Accepting new patients |
Locations
6612 Gulton Ct NE
Ste B
Albuquerque, NM 87109
Phone (505) 633-7886
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1588320576
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1609760115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6612 GULTON CT NE STE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094407",
"telephone_number": "505-633-7886",
"fax_number": "505-521-5165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6612 GULTON CT NE STE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094407",
"telephone_number": "505-633-7886",
"fax_number": "505-521-5165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TKACZYK",
"first_name": "HEATHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-07",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NM",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NM",
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": null,
"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 Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.