Individual provider Active NPI

Kirsten M Hockemeier, LISW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1902815525
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-3387 Issued in NM
Practice address
2601 Wyoming Blvd NE
Suite 101
Albuquerque, NM 87112
Phone
(505) 404-0717
Fax
(505) 999-1172
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LISW - I-3387 NM
Clinical Social Worker 1041C0700X I-3387 NM Primary

Addresses

Primary practice location

2601 Wyoming Blvd NE
Suite 101
Albuquerque, NM 87112

Mailing address

1600 San Pedro Dr NE
Albuquerque, NM 87110-6734
Phone (505) 404-0717

Other identifiers 3

IdentifierTypeStateIssuer
11700402OtherCAQH
071433MedicaidNM
Z1433MedicaidNM

Other names 1

  • Mrs. Kirsten M Choubard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091210000237 NM Practitioner - Clinical Social Worker 3173528973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 San Pedro Dr NE
Albuquerque, NM 87110-6734
Phone (877) 818-6054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-3387NMMDClinical Social Worker
LISW - I-3387NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling World, LLC Clinical CurrentSince Oct 1, 2009 Accepting new patients

Locations

2601 Wyoming Blvd NE
Ste 101
Albuquerque, NM 87112
Phone (505) 315-3001

1600 San Pedro Dr NE
Albuquerque, NM 87110
Phone (505) 404-0717

1400 Barbara Loop SE
Ste D4
Rio Rancho, NM 87124
Phone (877) 818-6054

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1902815525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SAN PEDRO DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871106734",
            "telephone_number": "505-404-0717",
            "fax_number": "505-999-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 WYOMING BLVD NE",
            "address_2": "SUITE 101",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87112",
            "telephone_number": "505-404-0717",
            "fax_number": "505-999-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCKEMEIER",
        "first_name": "KIRSTEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "LISW - I-3387",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-3387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11700402",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071433",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z1433",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "CHOUBARD",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.