Healthcare Provider Details

I. General information

NPI: 1144925033
Provider Name (Legal Business Name): SARDONYX ADELHEID WHALEN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 MONTGOMERY BLVD NE UNIT A
ALBUQUERQUE NM
87109-1210
US

IV. Provider business mailing address

1017 WALKER DR NE
ALBUQUERQUE NM
87112-5252
US

V. Phone/Fax

Practice location:
  • Phone: 505-369-1275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2024-0041
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: