Individual provider Active NPI

Sherilyn Marie Oberlin, LLPC

  • Mental Health Counselor
  • Las Cruces, NM
National Provider Identifier
1194142729
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CCMH0180421 Issued in NM
Practice address
1635 S Don Roser Dr
Las Cruces, NM 88011-4550
Phone
(575) 636-2506
NPI assigned
Mar 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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 CCMH0180421 NM Primary

Addresses

Primary practice location

1635 S Don Roser Dr
Las Cruces, NM 88011-4550

Mailing address

1635 S Don Roser Dr
Las Cruces, NM 88011-4550
Phone (575) 636-2506

Other identifiers 1

IdentifierTypeStateIssuer
34722751MedicaidNM

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
I20240611001697 NM Practitioner - Mental Health Counselor 3274075841 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Medical Group PA Mental Health CurrentSince Jun 1, 2024 Accepting new patients
Inetmed RX2 Inc. CurrentSince Jun 9, 2024 Accepting new patients

Locations

1635 S Don Roser Dr
Las Cruces, NM 88011
Phone (575) 522-1241

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1194142729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 S DON ROSER DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114550",
            "telephone_number": "575-636-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 S DON ROSER DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114550",
            "telephone_number": "575-636-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERLIN",
        "first_name": "SHERILYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CCMH0180421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34722751",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.