NPIMap

Organization Active NPI

Phoenix Group-Psychiatry and Psychotherapy Specialists, LTD

  • Psychologist
  • Albuquerque, NM
National Provider Identifier
1902091622
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
798 Issued in NM
Legal business name
PHOENIX GROUP-PSYCHIATRY AND PSYCHOTHERAPY SPECIALISTS, LTD
Practice address
9426 Indian School Rd NE
#2
Albuquerque, NM 87112
Phone
(505) 342-0400
Fax
(505) 342-0500
NPI assigned
Sep 6, 2007
Last updated
Aug 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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

Authorized official

Name
Sherry Gribling
Title
Secretary of Corp
Phone
(505) 342-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 798 NM Primary

Addresses

Primary practice location

9426 Indian School Rd NE
#2
Albuquerque, NM 87112

Mailing address

9426 Indian School Rd NE
#2
Albuquerque, NM 87112
Phone (505) 342-0400

Other names 1

  • Phoenix Group Other name

National Provider Directory

National Provider Directory

Locations

9426 Indian School Rd NE
Ste 2
Albuquerque, NM 87112
Phone (505) 342-0400

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1902091622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9426 INDIAN SCHOOL RD NE",
            "address_2": "#2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87112",
            "telephone_number": "505-342-0400",
            "fax_number": "505-342-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9426 INDIAN SCHOOL RD NE",
            "address_2": "#2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87112",
            "telephone_number": "505-342-0400",
            "fax_number": "505-342-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX GROUP-PSYCHIATRY AND PSYCHOTHERAPY SPECIALISTS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "GRIBLING",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "SECRETARY OF CORP",
        "authorized_official_telephone_number": "505-342-0400"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 12, 2008; 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.