Individual provider Active NPI

Abigail Eileen Omlor, LPCC LPAT ATR-BC

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1124451158
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CCMH0178791 Issued in NM
Practice address
12836 Lomas Blvd NE Ste B
Albuquerque, NM 87112-6200
Phone
(920) 202-4427
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CCMH0178791 NM Primary

Addresses

Primary practice location

12836 Lomas Blvd NE Ste B
Albuquerque, NM 87112-6200

Mailing address

12836 Lomas Blvd NE Ste B
Albuquerque, NM 87112-6200
Phone (920) 202-4427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611002814 NM Practitioner - Mental Health Counselor 9931540135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CCMH0178791NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Counseling Mental Health CurrentSince Apr 22, 2024 Accepting new patients

Locations

12836 Lomas Blvd NE
Ste B
Albuquerque, NM 87112
Phone (505) 275-7795

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1124451158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12836 LOMAS BLVD NE STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871126200",
            "telephone_number": "920-202-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12836 LOMAS BLVD NE STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871126200",
            "telephone_number": "920-202-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMLOR",
        "first_name": "ABIGAIL",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "LPCC LPAT ATR-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0178791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.