NPIMap

Organization Active NPI

Outside the Box Counseling

  • Adult Mental Health Clinic/Center
  • Estancia, NM
National Provider Identifier
1114686649
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
OUTSIDE THE BOX COUNSELING
Practice address
4 Audra Loop
Estancia, NM 87016
Phone
(505) 750-0105
NPI assigned
Dec 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Authorized official

Name
Jennifer Nelson, LCSWNPI 1639648736
Title
Therapist
Phone
(505) 750-0105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

4 Audra Loop
Estancia, NM 87016

Mailing address

PO Box 1080
Estancia, NM 87016-1080
Phone (505) 750-0105

Other identifiers 1

IdentifierTypeStateIssuer
39077560MedicaidNM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1114686649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "ESTANCIA",
            "state": "NM",
            "postal_code": "870161080",
            "telephone_number": "505-750-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 AUDRA LOOP",
            "city": "ESTANCIA",
            "state": "NM",
            "postal_code": "87016",
            "telephone_number": "505-750-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTSIDE THE BOX COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "505-750-0105",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39077560",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Estancia, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.