Derek Rugsaken, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CCMH0219111 Issued in NM

Practice address

1200 N Paseo de Onate
Espanola, NM 87532-2687

Phone

(765) 748-6139

NPI assigned

Aug 19, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1083080477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "DIXON",
            "state": "NM",
            "postal_code": "875270151",
            "telephone_number": "765-748-6139"
        },
        {
            "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": "765-748-6139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Spruce St Ste B",
            "address_purpose": "LOCATION",
            "city": "Espanola",
            "state": "NM",
            "postal_code": "875323455",
            "country_code": "US",
            "telephone_number": "505-699-9420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGSAKEN",
        "first_name": "DEREK",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0219111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xochitl Romero, PA-C
• Stacey Romick-Imig
• Hannah Felice Rosacker
• Elena Roybal
• Juan Roybal I
• Robert Nathaniel Rush
• Mercy Burton Russell, LCSW
• Kristine Rutledge
• RVC, Inc.
• William M Ryan, MD

• Professional Counselor in Espanola, NM
• Providers in Espanola, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.