Individual provider Active NPI

Charlotte Ebner

  • Mental Health Counselor
  • Rio Rancho, NM
National Provider Identifier
1164965661
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1316 Jackie Rd SE Ste 900
Rio Rancho, NM 87124-6612
Phone
(505) 404-9892
NPI assigned
Dec 1, 2016
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1316 Jackie Rd SE Ste 900
Rio Rancho, NM 87124-6612

Mailing address

1316 Jackie Rd SE Ste 900
Rio Rancho, NM 87124-6612
Phone (505) 404-9892

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma Treatment Center LLC Mental Health CurrentSince Jan 26, 2025 Accepting new patients

Locations

1316 Jackie Rd SE
Ste 900
Rio Rancho, NM 87124
Phone (505) 289-1042

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1164965661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 900",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246612",
            "telephone_number": "505-404-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 900",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246612",
            "telephone_number": "505-404-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBNER",
        "first_name": "CHARLOTTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 22, 2025; 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.