Healthcare Provider Details

I. General information

NPI: 1992321079
Provider Name (Legal Business Name): STEPHANIE RHIANNON KITTS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 WASHINGTON ST SE STE E
ALBUQUERQUE NM
87108-2713
US

IV. Provider business mailing address

607 GRIEGOS RD NW
ALBUQUERQUE NM
87107-3740
US

V. Phone/Fax

Practice location:
  • Phone: 505-458-6727
  • Fax:
Mailing address:
  • Phone: 317-727-7690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2024-0201
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: