Individual provider Active NPI

Maria Pangborn, MS, LMHC

  • Mental Health Counselor
  • Las Cruces, NM
National Provider Identifier
1063118396
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CTB-2022-0999 Issued in NM
Practice address
128 Wyatt Dr
Las Cruces, NM 88005-2925
Phone
(575) 882-5100
Fax
(575) 882-1151
NPI assigned
Feb 7, 2023
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CTB-2022-0999 NM Primary

Addresses

Primary practice location

128 Wyatt Dr
Las Cruces, NM 88005-2925

Mailing address

PO Box 2671
Anthony, NM 88021-2671
Phone (575) 882-5100

Other practice location 1

785 Anthony Drive
Anthony, NM 88021
Phone (575) 882-5100

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CTB-2022-0999NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Amanecer Community Counseling Center PastSince Feb 27, 2017 Accepting new patients
Amanecer Community Counseling Center PastSince Feb 12, 2023 Accepting new patients
Amanecer Community Counseling Center, LLC Past Accepting new patients

Organizations & group practices 3

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": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1063118396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2671",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "880212671",
            "telephone_number": "575-882-5100",
            "fax_number": "575-882-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 WYATT DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052925",
            "telephone_number": "575-882-5100",
            "fax_number": "575-882-1151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "785 Anthony Drive",
            "address_purpose": "LOCATION",
            "city": "Anthony",
            "state": "NM",
            "postal_code": "88021",
            "country_code": "US",
            "telephone_number": "575-882-5100",
            "fax_number": "575-882-1151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANGBORN",
        "first_name": "MARIA",
        "credential": "MS, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2022-0999",
            "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 Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.