Active NPI
Leland Guthrie
- Clinical Psychologist
- Santa Fe, NM
National Provider Identifier
1871246819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY1711
- Practice address
- 1421 Luisa St Ste O
Santa Fe, NM 87505-4073 - Phone
- (505) 927-9169
- NPI assigned
- Jan 31, 2022
- Last updated
- Jan 31, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY1711 | NM | Primary |
Addresses
Primary practice location
1421 Luisa St Ste O
Santa Fe, NM 87505-4073
Mailing address
12B Eckards Way
Espanola, NM 87532-9878
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1711 | NM | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Obsidian Psychotherapy, LLC | Current | Accepting new patients |
Locations
1482 S Saint Francis Dr
Ste B
Santa Fe, NM 87505
Phone (505) 670-8797
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Santa Fe, NM
- NPI 1063145738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643587200000",
"number": "1871246819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12B ECKARDS WAY",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875329878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 LUISA ST STE O",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054073",
"telephone_number": "505-927-9169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTHRIE",
"first_name": "LELAND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-31",
"last_updated": "2022-01-31",
"certification_date": "2022-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "PSY1711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.