MEDICARE: KYLE ROUCKUS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SWB-2023-1127	NM

General Provider Information

NPI Number	:	1003587551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE ROUCKUS LCSW

Provider Business Mailing Address
First Line	:	528 CARLISLE BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-1323
Country	:	US
Telephone Number	:	505-363-3313
Fax Number	:

Provider Business Practice Location Address
First Line	:	528 CARLISLE BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-1323
Country	:	US
Telephone Number	:	505-363-3313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2021
Last Update Date	:	01/16/2024

Similar Medicare Providers

1215525902 — AUGUST VOJDANI PA-C
Practice Location Address:

4588 PARADISE BLVD NW , MEDICARE ADVANTAGE CLINIC
ALBUQUERQUE, NM
87114-4105

Practice Phone: 505-998-1840
Practice Fax: 505-998-1841

1144768326 — TYLER MONTGOMERY MOUND
Practice Location Address:

1323 COPPER AVE NE
ALBUQUERQUE, NM
87106-4601

Practice Phone: 505-910-7016
Practice Fax:

1225196256 — MISS RACHEL E HAWKINS MA, CCC-SLP
Practice Location Address:

6910 NATALIE AVE NE
ALBUQUERQUE, NM
87110-1323

Practice Phone: 505-881-9227
Practice Fax: 505-881-9441

1205989456 — PAMELA PAYTON OT
Practice Location Address:

6910 NATALIE AVE NE , CLEVELAND MS
ALBUQUERQUE, NM
87110-1323

Practice Phone: 505-881-9227
Practice Fax:

1821214610 — MARIA LYDIA AVENDANO SW
Practice Location Address:

6910 NATALIE AVE NE , CLEVELAND MS
ALBUQUERQUE, NM
87110-1323

Practice Phone: 505-881-9227
Practice Fax:

1710211057 — MRS. HEATHER L. SHORTZ LPCC
Practice Location Address:

2600 MARBLE AVE NE
ALBUQUERQUE, NM
87106-2058

Practice Phone: 505-925-0612
Practice Fax:

Directions to “ KYLE ROUCKUS LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.