Organization Active NPI

Vista Clara Counseling LLC

  • Mental Health Counselor
  • Moriarty, NM
National Provider Identifier
1114690443
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
VISTA CLARA COUNSELING LLC
Practice address
2005 RT 66 W
Suite F
Moriarty, NM 87035
Phone
(505) 433-8822
NPI assigned
Aug 2, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Sara Sadie Lombardi, MS, LPCCNPI 1578071999
Title
Owner/Manager
Phone
(505) 433-8822

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

Practitioners 2

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

National Provider Directory

National Provider Directory

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

NPPES NPI Registry

Primary practice location

2005 RT 66 W
Suite F
Moriarty, NM 87035

Mailing address

PO Box 2732
Moriarty, NM 87035-2732
Phone (505) 433-8822

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
77179579MedicaidNM

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 2, 2021.

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1114690443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2732",
            "city": "MORIARTY",
            "state": "NM",
            "postal_code": "870352732",
            "telephone_number": "505-433-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 RT 66 W",
            "address_2": "SUITE F",
            "city": "MORIARTY",
            "state": "NM",
            "postal_code": "87035",
            "telephone_number": "505-433-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA CLARA COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "LOMBARDI",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "SADIE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "505-433-8822",
        "authorized_official_credential": "MS, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77179579",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moriarty, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.