Individual provider Active NPI

Elena Matthews

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1104595719
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CCMH0219101 Issued in NM
Practice address
6303 4TH St NW Ste 1
Albuquerque, NM 87107-5855
Phone
(505) 903-4413
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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 CCMH0219101 NM Primary

Addresses

Primary practice location

6303 4TH St NW Ste 1
Albuquerque, NM 87107-5855

Mailing address

3532 Yosemite Dr NE
Albuquerque, NM 87111-5450
Phone (505) 980-0119

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
I20240307000864 NM Practitioner - Mental Health Counselor 1153767611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Engage and Ignite CounselingGroup PAC ID 9830534213, 4 clinicians

Practice addresses (Care Compare)

6303 4TH St NW
Suite 1
Los Ranchos, NM 87107-5855
Phone (505) 903-4413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CCMH0219101NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Engage and Ignite Counseling CurrentSince Jan 1, 2024 Accepting new patients

Locations

6303 4th St NW
Ste 1
Los Ranchos, NM 87107
Phone (505) 321-0906

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1104595719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3532 YOSEMITE DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115450",
            "telephone_number": "505-980-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6303 4TH ST NW STE 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871075855",
            "telephone_number": "505-903-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "ELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0219101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.