Organization
KINTSUGI BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VYVIAN PHAN LCSW (CO-OWNER)
(505) 702-9080
Entity
Organization
Contact information
Practice address
948 CAMINO DE LA TIERRA, CORRALES, NM 87048-6909
(505) 352-4674
Mailing address
948 CAMINO DE LA TIERRA, CORRALES, NM 87048-6909
(505) 352-4674
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/21/2025
Last updated
01/28/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up