Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1417174848 Individual Practitioner Female Practitioner

Phyllis Pine

Psychologist - School • Gallup, NM

Professional Overview & Biography Verified Profile Summary

Phyllis Pine is a registered healthcare professional specializing in Psychologist - School in Gallup, NM. Practice services are available at 1000 E AZTEC AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1000 E Aztec Ave

Gallup, NM 873015509

Telephone 5057211800
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - School in Gallup, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.4 Yrs
Regional Practice Density
5 Specialists

Practicing in Gallup, NM (251 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - School Primary Specialty

NUCC Taxonomy Code: 103TS0200X

State License NM 257139

A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
47809876 (NM)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

28 Associated Practitioners
Karen Kohler , OTRL

Occupational Therapist

NPI 1013132356

Occupational Therapist Registered & Licensed

Kendra Kennedy

Speech-Language Pathologist

NPI 1033340427
Brenda Machain , SLP

Speech-Language Pathologist

NPI 1073644126

Speech-Language Pathologist

Nancy Canto

Physical Therapist

NPI 1174655872
Anne- Marie Cotter

Speech-Language Pathologist

NPI 1306077789
Mary Sanchez , MS, CCC-SLP

Speech-Language Pathologist

NPI 1316079023

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 1000 E AZTEC AVE, GALLUP, NM 873015509 (Tel: 5057211800)

📍
Updated Business Mailing Address July 08, 2007

Registered at 222 NIZHONI BLVD APT E4, GALLUP, NM 873015764 (Tel: 5057932727)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as PHYLLIS PINE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #257139 in NM)

🟢
Initial NPI Registration & Enumeration April 19, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417174848
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 19, 2007
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

222 Nizhoni Blvd Apt E4

Gallup, NM 873015764

Phone: 5057932727

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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