Healthcare Provider Details

I. General information

NPI: 1639093974
Provider Name (Legal Business Name): KAIZEN PSYCHOLOGICAL SERVICES L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 MOUNTAIN ROAD PL NE # 12351
ALBUQUERQUE NM
87110-7825
US

IV. Provider business mailing address

1209 MOUNTAIN ROAD PL NE # 12351
ALBUQUERQUE NM
87110-7825
US

V. Phone/Fax

Practice location:
  • Phone: 505-505-9659
  • Fax:
Mailing address:
  • Phone: 505-505-9659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SURABHI SWAMINATH
Title or Position: OWNER AND LICENSED PSYCHOLOGIST
Credential: PH.D.
Phone: 505-505-9659