Graciela Ponce, LPCC
Individual provider Active NPI Professional Counselor · La Mesa, NM
NPI 1205545662 · NPPES record last updated Oct 29, 2024
Key facts
- NPI
- 1205545662
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CTB-2024-0609 (NM)
- Practice address
- 18420 S Highway 28
La Mesa, NM 88044-9605 - Phone
- (575) 233-3830
- Fax
- (575) 233-4542
- NPI assigned
- Nov 15, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 20
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- La Clinica de Familia Incorporated
Practice addresses (Care Compare)
18420 S Hwy 28
LCDF San Miguel Medical
La Mesa, NM 88044-9605
Phone (575) 233-3830
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241105002935 | NM | Practitioner - Mental Health Counselor | 3678007200 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CMH0204121 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de Familia, Incorporated | Current |
Accepting new patients | |
| La Clinica de Familia, Incorporated | Current | Accepting new patients | |
| La Clinica de Familia, Incorporated | Current |
Accepting new patients |
Locations
826 Anthony Dr
Anthony, NM 88021
Phone (575) 201-5135
855 Anthony Dr
Anthony, NM 88021
Phone (575) 882-3607
18420 S Highway 28
La Mesa, NM 88044
Phone (575) 233-3830
385 Calle de Alegra
Bldg A
Las Cruces, NM 88005
Phone 57552611052444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CMH0204121 | NM | |
| Professional Counselor | 101YP2500X | CTB-2024-0609 | NM | Yes |
Addresses
Primary practice location
18420 S Highway 28
La Mesa, NM 88044-9605
Mailing address
385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105
Other names
- Graciela Torres
Other providers in La Mesa, NM
- Michelle Mandy Li
- Blanca Martinez
- Maximo Martinez
- Derek Merchant
- Abby Anne Pedroza
- Amanda E Sanford
- Lillian Sierra
- Walker Eaze LLC
All providers in La Mesa, NM · Professional Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.