NPIMap

Organization Active NPI

4 Directions Integrative Mental Health, LLC

  • Community/Behavioral Health Agency
  • Las Cruces, NM
National Provider Identifier
1013559038
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
4 DIRECTIONS INTEGRATIVE MENTAL HEALTH, LLC
Practice address
125 W Boutz Rd
Las Cruces, NM 88005-3118
Phone
(575) 523-5222
Fax
(575) 523-8031
NPI assigned
Oct 10, 2019
Last updated
Aug 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Annette Mirabal, LCSW, LADACNPI 1053780023
Title
Partner
Phone
(575) 520-1536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

125 W Boutz Rd
Las Cruces, NM 88005-3118

Mailing address

PO Box 3148
Mesilla Park, NM 88047-3148
Phone (575) 523-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200407001499 NM Part B Supplier - Clinic/Group Practice 1153750476 Receives reassigned benefits from 6 practitioners
Practice locations: Las Cruces, NM

National Provider Directory

National Provider Directory

Locations

125 W Boutz Rd
Las Cruces, NM 88005
Phone (575) 523-5222

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1013559038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3148",
            "city": "MESILLA PARK",
            "state": "NM",
            "postal_code": "880473148",
            "telephone_number": "575-523-5222",
            "fax_number": "575-523-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W BOUTZ RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053118",
            "telephone_number": "575-523-5222",
            "fax_number": "575-523-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4 DIRECTIONS INTEGRATIVE MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "MIRABAL",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "575-520-1536",
        "authorized_official_credential": "LCSW, LADAC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.