Individual provider Active NPI

Maryanne Esabella Miceli

  • Addiction (Substance Use Disorder) Counselor
  • Albuquerque, NM
National Provider Identifier
1184454530
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CTB-2025-0871 Issued in NM
Practice address
13139 Central Ave NE
Albuquerque, NM 87123-3031
Phone
(505) 459-5054
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CTB-2025-0871 NM Primary
Peer Specialist 175T00000X 1889 NM
Community Health Worker 172V00000X NM

Addresses

Primary practice location

13139 Central Ave NE
Albuquerque, NM 87123-3031

Mailing address

13139 Central Ave NE
Albuquerque, NM 87123-3031
Phone (505) 459-5054

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

State licenses

LicenseStateTypeSpecialty
CTB-2025-0871NMMDAddiction (Substance Use Disorder) Counselor
1889NMMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1184454530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13139 CENTRAL AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871233031",
            "telephone_number": "505-459-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13139 CENTRAL AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871233031",
            "telephone_number": "505-459-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "MARYANNE",
        "middle_name": "ESABELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CTB-2025-0871",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NM",
            "license": "1889",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NM",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.