MEDICARE: KIND MIND NM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1477493328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIND MIND NM LLC

Provider Business Mailing Address
First Line	:	1109 WESTERN MEADOWS RD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-1930
Country	:	US
Telephone Number	:	505-582-6684
Fax Number	:

Provider Business Practice Location Address
First Line	:	1109 WESTERN MEADOWS RD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-1930
Country	:	US
Telephone Number	:	505-582-6684
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTY JOHNSON
Credential	:	LCSW
Telephone Number	:	505-582-6684

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	03/31/2026

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Directions to “KIND MIND NM LLC ” Practice Location

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