Johanna Depalma

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

T-0163671 Issued in NM

Practice address

8600 Academy Rd NE
Albuquerque, NM 87111-1107

Phone

(505) 821-3628

Fax

(505) 821-3628

NPI assigned

Jan 31, 2014

Last updated

Mar 20, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Johanna Depalma Former name

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Formation Counseling Services IncGroup PAC ID 9335387224, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Formation Counseling Services Inc

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1033274535
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1023431673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 SPAIN RD NE",
            "address_2": "SUITE 106",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093179",
            "telephone_number": "505-856-0300",
            "fax_number": "505-856-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 ACADEMY RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111107",
            "telephone_number": "505-821-3628",
            "fax_number": "505-821-3628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8205 Spain Rd NE",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871093179",
            "country_code": "US",
            "telephone_number": "505-856-0300",
            "fax_number": "505-856-7946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPALMA",
        "first_name": "JOHANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0166611",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T-0163671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "DEPALMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Patricia Dentinger, SLP-CF
• Phyllis McCurdy Denton, LPCC
• P Jon Depalma
• Department of Behavioral Health
• Department of Veterans Affairs
• Brittany Depasquale, M.D.
• Julia D Depaula

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.