Individual provider Active NPI

Wayne A Salazar, LSAA

  • Addiction (Substance Use Disorder) Counselor
  • Espanola, NM
National Provider Identifier
1124351416
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0067372 Issued in NM
Practice address
1114 Plaza del Norte Ste B
Espanola, NM 87532-3216
Phone
(505) 753-8933
Fax
(505) 753-9811
NPI assigned
Sep 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0067372 NM Primary

Addresses

Primary practice location

1114 Plaza del Norte Ste B
Espanola, NM 87532-3216

Mailing address

1114 Plaza del Norte Ste B
Espanola, NM 87532-3216
Phone (505) 753-8933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0067372NMMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1124351416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 PLAZA DEL NORTE STE B",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875323216",
            "telephone_number": "505-753-8933",
            "fax_number": "505-753-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 PLAZA DEL NORTE STE B",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875323216",
            "telephone_number": "505-753-8933",
            "fax_number": "505-753-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "WAYNE",
        "middle_name": "A",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-17",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0067372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Espanola, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.