National Provider Identifier Database

KERRI WORMWOOD LLC
Professional


Contact Information

KERRI WORMWOOD, LLC
3200 CARLISLE NE, SUITE 204
ALBUQUERQUE, NM87110
Phone: 505-604-1222
Fax: 505-889-4598
Website:
Specialty Taxonomy Code
* Professional 101YP2500X
Art Therapist 221700000X

* Indicates primary specialty

NPI Profile & details for KERRI WORMWOOD, LLC

NPI Number 1336509348
Legal business name
LBN
KERRI WORMWOOD, LLC
Authorized official KERRI WORMWOOD - (CLINICAL COUNSELOR AND ART THERAPIS)
Entity Organization
Organization subpart No
Enumeration date 03/03/2016
Last updated 03/03/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: 1128
  • NM License #: 1129
  • NM Medicaid: 000A1775

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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