Individual provider Active NPI

John Heinrich Reiser, LPCC

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1104160431
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CTB-2022-0839 Issued in NM
Practice address
7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314
Phone
(505) 884-1114
Fax
(505) 884-3004
NPI assigned
Nov 27, 2012
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CTB-2022-0839 NM Primary

Addresses

Primary practice location

7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314

Mailing address

3100 Jane PL NE
Albuquerque, NM 87111-5140
Phone (505) 913-0392

Other identifiers 1

IdentifierTypeStateIssuer
41832809MedicaidNM

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
I20241219001165 NM Practitioner - Mental Health Counselor 8123555836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sage Neuroscience Center IncGroup PAC ID 5395840383, 23 clinicians

Practice addresses (Care Compare)

7850 Jefferson St NE
Suite 300
Albuquerque, NM 87109-4314
Phone (505) 884-1114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CTB-2022-0839NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Neuroscience Center Inc Mental Health CurrentSince Oct 28, 2024 Accepting new patients

Locations

7850 Jefferson St NE
Ste 300
Albuquerque, NM 87109
Phone (505) 884-1114

Organizations & group practices 1

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": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1104160431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 JANE PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115140",
            "telephone_number": "505-913-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 JEFFERSON ST NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094314",
            "telephone_number": "505-884-1114",
            "fax_number": "505-884-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISER",
        "first_name": "JOHN",
        "middle_name": "HEINRICH",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CTB-2022-0839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41832809",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.