Krystalena Chischilly, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0159961 Issued in NM

Practice address

707 Broadway Blvd NE Ste 500
Albuquerque, NM 87102-2367

Phone

(505) 268-0701

Fax

(505) 232-9055

NPI assigned

Aug 12, 2014

Last updated

Aug 12, 2014By the provider in NPPES

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": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1740699065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 BROADWAY BLVD NE STE 500",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022367",
            "telephone_number": "505-268-0701",
            "fax_number": "505-232-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 BROADWAY BLVD NE STE 500",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022367",
            "telephone_number": "505-268-0701",
            "fax_number": "505-232-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISCHILLY",
        "first_name": "KRYSTALENA",
        "name_prefix": "Ms.",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0159961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank T Chinisci, OD
• Janice Chino Acton
• Sunflower Chirieleison, MPT
• Chiropractic Arts
• Chiropractic Lifestyle Center, P.C.
• Douglas Paul Chisholm, DMD
• Kelly Chisholm, LPCC
• Haywan Chiu, DPM
• Mark T. Chiu, M.D.
• Toby Chiu, PHARMD

• Addiction (Substance Use Disorder) Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.