Individual provider Active NPI

Amy Vialpando, LMHC

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1174008395
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CCMH0214071 Issued in NM
Practice address
5916 Anaheim Ave NE Ste a
Albuquerque, NM 87113-1894
Phone
(505) 291-6314
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CMH0199611 NM
Professional Counselor 101YP2500X CCMH0214071 NM Primary

Addresses

Primary practice location

5916 Anaheim Ave NE Ste a
Albuquerque, NM 87113-1894

Mailing address

5916 Anaheim Ave NE Ste a
Albuquerque, NM 87113-1894
Phone (505) 291-6314

Other identifiers 1

IdentifierTypeStateIssuer
CMH0199611OtherNMNM COUNSELING AND THERAPY BOARD

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
I20250130003527 NM Practitioner - Mental Health Counselor 4082143326 Practice locations: Albuquerque, NM

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11811 Menaul Blvd NE
Suite 4
Albuquerque, NM 87112-2464
Phone (505) 377-5130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CMH0199611NMMDMental Health Counselor
CCMH0214071NMMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1174008395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 ANAHEIM AVE NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131894",
            "telephone_number": "505-291-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5916 ANAHEIM AVE NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131894",
            "telephone_number": "505-291-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIALPANDO",
        "first_name": "AMY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CMH0199611",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0214071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM COUNSELING AND THERAPY BOARD",
            "identifier": "CMH0199611",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.