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General NPI Number Information
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NPI Number | 1457261265
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Entity Type | Individual
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Provider Name | KENNETH PATRICK CHAVEZ MA, MS, LMHC
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Gender | Male
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 1 UNIVERSITY OF NEW MEXICO # 63870
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-277-3136
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Fax |
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Provider Business Mailing Address
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Address Line | 6000 CORTADERIA ST NE APT 6202
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-8007
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Country | US
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Telephone | 505-369-9314
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CTB-2026-0598
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License Number State | NM
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