Kellen Dean
Individual provider Active NPI Community/Behavioral Health Agency · Bloomfield, NM
NPI 1962010199 · NPPES record last updated Jan 19, 2023
Key facts
- NPI
- 1962010199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Practice address
- 101 E Broadway Ave
Bloomfield, NM 87413-6235 - Phone
- (505) 330-8220
- NPI assigned
- Jul 14, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angel Peak Counseling, LLC | Current |
Accepting new patients | |
| Sadie L Smith-McDaniel | Community/Behavioral Health | Current |
Accepting new patients |
Locations
101 E Broadway Ave
Bloomfield, NM 87413
Phone (505) 330-8220
114 N Behrend Ave
Farmington, NM 87401
Phone (505) 326-2736
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
101 E Broadway Ave
Bloomfield, NM 87413-6235
Mailing address
101 E Broadway Ave
Bloomfield, NM 87413-6235
Phone (505) 947-4384
Other practice location 1
114 N Behrend Ave
Farmington, NM 87401-8414
Phone (505) 330-8220
Other providers in Bloomfield, NM
- Cynthia Colson
- Sharon Flora Cooke
- Brandon Ira Crockett
- Telecia Crockett
- Anna Marie Curtis
- Karen Dennis
- Nicole Marie Desouchet
- Deanna Devore
- DHHS PHS Naihs Shiprock Hospital
- DHHS PHS Naihs Shiprock Hospital
All providers in Bloomfield, NM · Community/Behavioral Health Agency in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.