Active NPI
Jennifer Paige Pierson, LPC, LPCC
- Professional Counselor
- Espanola, NM
National Provider Identifier
1053715714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0188171
- Practice address
- 1200 N Paseo de Onate
Espanola, NM 87532-2687 - Phone
- (505) 747-0081
- NPI assigned
- Oct 9, 2014
- Last updated
- Apr 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 69912 | TX | |
| Professional Counselor | 101YP2500X | 0188171 | NM | Primary |
Addresses
Primary practice location
1200 N Paseo de Onate
Espanola, NM 87532-2687
Mailing address
PO Box 800
Santa Cruz, NM 87567-0800
Phone (505) 692-5472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69912 | TX | MD | Mental Health Counselor |
| 0188171 | NM | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Medical Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Los Alamos, NM
- NPI 1699237982
-
dba Espanola Family Wellness Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Espanola, NM
- NPI 1942650445
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1053715714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 800",
"city": "SANTA CRUZ",
"state": "NM",
"postal_code": "875670800",
"telephone_number": "505-692-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N PASEO DE ONATE",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322687",
"telephone_number": "505-747-0081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERSON",
"first_name": "JENNIFER",
"middle_name": "PAIGE",
"credential": "LPC, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-09",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "69912",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "0188171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.