Individual provider Active NPI

Lisa Whitney Swanson

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1033419577
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CCMH0193841 Issued in NM
Practice address
2537 Aspen Ave NW
Albuquerque, NM 87104-1919
Phone
(505) 206-5460
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0193841 NM
Mental Health Counselor 101YM0800X T-0134911 NM
Mental Health Counselor 101YM0800X CCMH0193841 NM Primary

Addresses

Primary practice location

2537 Aspen Ave NW
Albuquerque, NM 87104-1919

Mailing address

3301R Coors Blvd NW # 265
Albuquerque, NM 87120-1229
Phone (505) 459-9301

Other names 1

  • Lisa Gomme Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240807004049 NM Practitioner - Mental Health Counselor 3375080310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Albuquerque, NM 87104
Phone (505) 206-5460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0193841NMMDMental Health Counselor
CCMH0193841NMMDMental Health Counselor
T-0134911NMMDMental Health Counselor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1033419577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301R COORS BLVD NW # 265",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201229",
            "telephone_number": "505-459-9301",
            "fax_number": "505-884-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 ASPEN AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871041919",
            "telephone_number": "505-206-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "LISA",
        "middle_name": "WHITNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0193841",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T-0134911",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CCMH0193841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "GOMME",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.