Individual provider Active NPI

Diane C. Chavez, MA, LPCC, LSAA

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1093873135
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0082381 Issued in NM
Practice address
4425 Juan Tabo Blvd NE Ste 112
Albuquerque, NM 87111-2684
Phone
(505) 503-6800
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 0082381 NM Primary

Addresses

Primary practice location

4425 Juan Tabo Blvd NE Ste 112
Albuquerque, NM 87111-2684

Mailing address

801 Guaymas PL NE
Albuquerque, NM 87108-2331
Phone (505) 238-7468

Other practice location 1

801 Guaymas Pl NE
Albuquerque, NM 87108-2331
Phone (505) 238-7468

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
I20250429000636 NM Practitioner - Mental Health Counselor 1153847595 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0082381NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elemental Health and Wellness Center LLC Mental Health CurrentSince Mar 10, 2025 Accepting new patients
Transformative Counseling Center LLC CurrentSince Apr 3, 2025 Accepting new patients

Locations

5111 San Mateo Blvd NE
Ste B2
Albuquerque, NM 87109
Phone (505) 238-7468

4425 Juan Tabo Blvd NE
Ste 112
Albuquerque, NM 87111
Phone (505) 503-6800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1093873135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 GUAYMAS PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082331",
            "telephone_number": "505-238-7468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 JUAN TABO BLVD NE STE 112",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112684",
            "telephone_number": "505-503-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Guaymas Pl NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871082331",
            "country_code": "US",
            "telephone_number": "505-238-7468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "DIANE",
        "middle_name": "C.",
        "credential": "MA, LPCC, LSAA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0082381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.