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Organization
ROUTE 66 PSYCHIATRY LLC
Active
Organization
ROUTE 66 PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER SHENK KOONTZ PMHNP-BC (OWNER)
(505) 226-1665
Entity
Organization
Contact information
Practice address
2917 SANTA CLARA AVE SE, ALBUQUERQUE, NM 87106-2946
(505) 226-1665
Mailing address
2917 SANTA CLARA AVE SE, ALBUQUERQUE, NM 87106-2946
(505) 226-1665
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/25/2026
Last updated
06/25/2026
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