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General NPI Number Information
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NPI Number | 1619668985
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Entity Type | Individual
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Provider Name | KEELY LUNDY
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Gender | Female
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 4801 LANG AVE NE STE 110
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4475
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Country | US
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Telephone | 801-609-8037
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone | 505-272-1476
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 431654
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY-2025-0003
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License Number State | NM
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