Active NPI
Darrel Richard Knutson, LMHC MA
- Professional Counselor
- Albuquerque, NM
National Provider Identifier
1902091531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0107091
- Practice address
- 4225 Montgomery Blvd NE
Albuquerque, NM 87109-1103 - Phone
- (505) 881-1820
- Fax
- (505) 881-1850
- NPI assigned
- Sep 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0107091 | NM | Primary |
Addresses
Primary practice location
4225 Montgomery Blvd NE
Albuquerque, NM 87109-1103
Mailing address
PO Box 16778
Albuquerque, NM 87191-6778
Phone (505) 489-1283
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0107091 | NM | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189036800000",
"number": "1902091531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16778",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871916778",
"telephone_number": "505-489-1283",
"fax_number": "505-292-4116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 MONTGOMERY BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091103",
"telephone_number": "505-881-1820",
"fax_number": "505-881-1850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTSON",
"first_name": "DARREL",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "LMHC MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-06",
"last_updated": "2007-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "0107091",
"primary": true
}
],
"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 Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.