Active NPI
Giselle Del Carmen Bango, LMFT
- Marriage & Family Therapist
- Rio Rancho, NM
National Provider Identifier
1144523200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- CMF0201891
- Practice address
- 2554 Shavano Peak Dr NE
Rio Rancho, NM 87144-6792 - Phone
- (828) 301-8171
- Fax
- (828) 333-5584
- NPI assigned
- Dec 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAD0212061 | NM | |
| Marriage & Family Therapist | 106H00000X | 1409 | NC | |
| Marriage & Family Therapist | 106H00000X | CMF0201891 | NM | Primary |
Addresses
Primary practice location
2554 Shavano Peak Dr NE
Rio Rancho, NM 87144-6792
Mailing address
2554 Shavano Peak Dr NE
Rio Rancho, NM 87144-6792
Phone (828) 301-8171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78850517 | Medicaid | NM | |
| 6105307 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 7, 2025 through Jan 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAD0212061 | NM | MD | Addiction (Substance Use Disorder) Counselor |
| CMF0201891 | NM | MD | Marriage & Family Therapist |
| 1409 | NC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1144523200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2554 SHAVANO PEAK DR NE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871446792",
"telephone_number": "828-301-8171",
"fax_number": "828-333-5584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2554 SHAVANO PEAK DR NE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871446792",
"telephone_number": "828-301-8171",
"fax_number": "828-333-5584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGO",
"first_name": "GISELLE",
"middle_name": "DEL CARMEN",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-13",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NM",
"license": "CAD0212061",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "1409",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NM",
"license": "CMF0201891",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78850517",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6105307",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.