Kim Cantrell, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-06910 Issued in NM

Legal business name

KIM CANTRELL, LLC

Practice address

2006 Southern Blvd SE Ste 203C
Rio Rancho, NM 87124-3758

Phone

(505) 362-3515

NPI assigned

Feb 27, 2013

Last updated

Feb 27, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kim Cantrell, LISW

Title

Owner

Phone

(505) 362-3515

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly H Cantrell, LISW

  • Clinical Social Worker
  • Rio Rancho, NM
  • NPI 1326288804
  Medicare reassignment NPD
• Marie Elizabeth Mugavin, PHD, FNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
  • NPI 1417186560
  NPD (past)

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1700126794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 SPAIN RD NE",
            "address_2": "SUITE 106",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093179",
            "telephone_number": "505-362-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 SOUTHERN BLVD SE STE 203C",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871243758",
            "telephone_number": "505-362-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM CANTRELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-362-3515",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-06910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99976307",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Kesler, BCBA
• Cindy Ketchum
• Nathan Ketchum
• KGH Services LLC (Synergy Counseling)
• Denise Marie Kielpinski, CPM,LM
• Yountae Kim
• Aaron Kimbrough
• Allison Kime
• Paula Kimlicka
• Paul Leonard King-Miller, PSYD, LPCC

• Clinical Social Worker in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.