Healthcare Provider Details

I. General information

NPI: 1316091994
Provider Name (Legal Business Name): SOUTHWEST PSYCHOLOGY ASSCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W COLLEGE AVE SUITE 19
SILVER CITY NM
88061-5002
US

IV. Provider business mailing address

301 W COLLEGE AVE SUITE 19
SILVER CITY NM
88061-5002
US

V. Phone/Fax

Practice location:
  • Phone: 505-388-4100
  • Fax:
Mailing address:
  • Phone: 505-388-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number693
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI2242
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number006042
License Number StateNM

VIII. Authorized Official

Name: DR. KENNETH A HUTCHINSON
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 505-388-4100