Jeremy L Nagorski

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CTB-2022-0828 Issued in NM

Practice address

8600 Academy Rd NE
Albuquerque, NM 87111-1107

Phone

(505) 821-3628

NPI assigned

Oct 24, 2022

Last updated

Oct 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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
  NPD

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1083331714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 ACADEMY RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111107",
            "telephone_number": "505-821-3628"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGORSKI",
        "first_name": "JEREMY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2022-0828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepshikha Nag Chowdhury, M.D
• Tomoki Nagano, M.D.
• Sivakumar Nagaraju, MD
• Barry D Nagel, MD
• Kalin Abigail Nagle, MS, CGC
• Maria Jennifer Vicuna Nagorski
• Ava Nagy
• Gavin Alexander Nagy, PHARMD
• Rachel Mae Nagy, LMFT
• Sandra Naigle

• 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 Oct 27, 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.