Provider Demographics
NPI:1912519968
Name:RICHTER, KAITLYN (LMSW)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:RICHTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 ROYENE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5838
Mailing Address - Country:US
Mailing Address - Phone:716-550-2668
Mailing Address - Fax:
Practice Address - Street 1:218 BROADWAY BLVD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3425
Practice Address - Country:US
Practice Address - Phone:505-242-6988
Practice Address - Fax:505-242-6972
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2022-0078104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker