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General NPI Number Information
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NPI Number | 1912519968
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Entity Type | Individual
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Provider Name | KAITLYN RICHTER LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 218 BROADWAY BLVD SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-3425
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Country | US
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Telephone | 505-242-6988
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Fax | 505-242-6972
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Provider Business Mailing Address
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Address Line | 4902 ROYENE AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-5838
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Country | US
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Telephone | 716-550-2668
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWB-2022-0078
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License Number State | NM
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