Indigo Grove Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

INDIGO GROVE COUNSELING LLC

Practice address

2717 Mesilla St NE
Albuquerque, NM 87110-3539

Phone

(505) 336-0154

NPI assigned

Oct 6, 2023

Last updated

Oct 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Aubrey Bassham, LCSWNPI 1326569757

Title

Clinician, Owner

Phone

(505) 336-0154

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aubrey Bassham

  • Social Worker
  • Albuquerque, NM
  • NPI 1326569757
  NPD Authorized official

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1134900087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 MESILLA ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 MESILLA ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103539",
            "telephone_number": "505-336-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO GROVE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-06",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "BASSHAM",
        "authorized_official_first_name": "AUBREY",
        "authorized_official_title_or_position": "CLINICIAN, OWNER",
        "authorized_official_telephone_number": "505-336-0154",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independence Care of New Mexico at Albuquerque LLC
• Independent Drug Testing and Forensic Services
• Independent Living Resource Center
• Independent Living Therapy Services, LLC
• Indian Health Service
• Indigo Midwifery
• Indigo Psychiatric Services
• Indigo Psychotherapy, LLC
• Indigo Sun Palliative Care
• Indigo Therapy Services, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.