Active NPI
Irene Gomez, MA, LMHC
- Mental Health Counselor
- Anthony, NM
National Provider Identifier
1114568656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CTL0204661
- Practice address
- 785 Anthony Drive
Anthony, NM 88021-2671 - Phone
- (575) 882-5100
- Fax
- (575) 882-1151
- NPI assigned
- Oct 7, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
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.
-
- Community/Behavioral Health Agency
- Santa Teresa, NM
- NPI 1033663984
-
- Community/Behavioral Health Agency
- Anthony, NM
- NPI 1669928982
-
- Marriage & Family Therapist
- Las Cruces, NM
- NPI 1194107060
-
- Adult Mental Health Clinic/Center
- West Des Moines, IA
- NPI 1679233183
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Evizzit of Iowa Psychiatry PC
Practice addresses (Care Compare)
1501 42ND St
Suite 575
West Des Moines, IA 50266-1060
Phone (855) 270-3625
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231215001171 | IA | Practitioner - Mental Health Counselor | 3971632902 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CTL0204661 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amanecer Community Counseling Center | Current | Accepting new patients | |
| Evizzit of Iowa Psychiatry PC | Current | Accepting new patients | |
| Counseling Las Cruces, LLC | Past | Accepting new patients | |
| Evizzit of Iowa Psychiatry PC | Past | Accepting new patients | |
| Amanecer Community Counseling Center, LLC | Past | Accepting new patients |
Locations
1501 42nd St
Ste 120
West Des Moines, IA 50266
1501 42nd St
Ste 575
West Des Moines, IA 50266
Phone 8552703625171
785 Anthony Dr
Anthony, NM 88021
Phone (575) 882-5100
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CTL0204661 | NM | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
785 Anthony Drive
Anthony, NM 88021-2671
Mailing address
PO Box 2671
Anthony, NM 88021-2671
Phone (575) 882-5100
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35650338 | Medicaid | NM |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 7, 2019.
{
"created_epoch": "1570406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570406400000",
"number": "1114568656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2671",
"city": "ANTHONY",
"state": "NM",
"postal_code": "880212671",
"telephone_number": "575-882-5100",
"fax_number": "575-882-1151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 ANTHONY DRIVE",
"city": "ANTHONY",
"state": "NM",
"postal_code": "880212671",
"telephone_number": "575-882-5100",
"fax_number": "575-882-1151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "IRENE",
"credential": "MA, LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-07",
"last_updated": "2019-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "CTL0204661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35650338",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anthony, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.