NPIMap

Organization Active NPI

State of New Mexico

Doing business as New Mexico Behavioral Health Institute @ Las Vegas

  • Psychoanalysis Psychologist
  • Las Vegas, NM
National Provider Identifier
1124211404
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychoanalysis PsychologistTaxonomy code 103TP0814X
Legal business name
STATE OF NEW MEXICO
Doing business as
New Mexico Behavioral Health Institute @ Las Vegas
Practice address
3695 Hot Springs Blvd
Las Vegas, NM 87701-9549
Phone
(505) 454-2100
NPI assigned
Aug 21, 2007
Last updated
Aug 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Authorized official

Name
Steve Martinez
Title
Interim Administrator
Phone
(505) 454-2203

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalysis Psychologist 103TP0814X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

3695 Hot Springs Blvd
Las Vegas, NM 87701-9549

Mailing address

3695 Hot Springs Blvd
Las Vegas, NM 87701-9549
Phone (505) 454-2100

Other identifiers 1

IdentifierTypeStateIssuer
96296MedicaidNM

Other names 1

  • NEW MEXICO BEHAVIORAL HEALTH INSTITUTE @ LAS VEGAS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Las Vegas Medical Cente10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1124211404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3695 HOT SPRINGS BLVD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877019549",
            "telephone_number": "505-454-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3695 HOT SPRINGS BLVD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877019549",
            "telephone_number": "505-454-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW MEXICO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "INTERIM ADMINISTRATOR",
        "authorized_official_telephone_number": "505-454-2203"
    },
    "taxonomies": [
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96296",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW MEXICO BEHAVIORAL HEALTH INSTITUTE @ LAS VEGAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.