Kitchen Table Counseling Professional LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KITCHEN TABLE COUNSELING PROFESSIONAL LLC

Practice address

333 E Jefferson St
Gallup, NM 87301-5113

Phone

(360) 433-7755

NPI assigned

Dec 7, 2020

Organization subpart

No

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

Authorized official

Name

Sandra Geary, LCSW

Title

Member

Phone

(360) 433-7755

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1861098857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E JEFFERSON ST",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015113",
            "telephone_number": "360-433-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E JEFFERSON ST",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015113",
            "telephone_number": "360-433-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITCHEN TABLE COUNSELING PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "GEARY",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "360-433-7755",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherman Earl King Jr., RN
• Jason Dale Kinyon, PHARMD
• Greg Allen Kirk, PT
• Paula Kirkendoll, RN
• Jan L Kiser, RN
• Amy Lynn Klann, RN
• Kristy M Klinger, PHARMD, PHC, BC-ADM,
• Anita Knapp, RN
• Adam Knappe, MD
• Anthony Carl Knight

• Clinical Social Worker in Gallup, NM
• Providers in Gallup, 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 Dec 7, 2020; 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.