Individual provider Active NPI

Desiree Woodard, BA

  • Student in an Organized Health Care Education/Training Program
  • Albuquerque, NM
National Provider Identifier
1780571547
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6612 Gulton CT NE Ste B
Albuquerque, NM 87109-4407
Phone
(505) 633-7886
Fax
(505) 521-5165
NPI assigned
Jun 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

6612 Gulton CT NE Ste B
Albuquerque, NM 87109-4407

Mailing address

PO Box 67216
Albuquerque, NM 87193-7216
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
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Sandia Therapy and Wellness Center Clinical CurrentSince Jun 29, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1780571547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67216",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871937216",
            "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": "WOODARD",
        "first_name": "DESIREE",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "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 3, 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.

Verify at the official NPI Registry.