| Doctor Name: | KERRY MENDES |
| NPI Number: | 1124348370 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1501 San Pedro Dr Se Albuquerque, NM - 871085153 |
| Business Phone Number: | 5052651711 |
| Business Fax Number: | 8004658262 |
| Mailing Address: | 933 Bradbury Dr Se Ste 2222, ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871064375 |
| Phone Number: | 5052723120 |
| Fax Number: | 5052728060 |
| NPI Enumeration Date: | 06/09/2010 |
| NPI Last Update Date: | 05/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |