Active NPI
Rebecca Evanko
- Mental Health Counselor
- Peralta, NM
National Provider Identifier
1205713708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CTB20250556
- Practice address
- 7 Wildwood LN
Peralta, NM 87042-8451 - Phone
- (505) 585-1958
- NPI assigned
- Aug 18, 2025
- Last updated
- Aug 18, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CTB20250556 | NM | Primary |
Addresses
Primary practice location
7 Wildwood LN
Peralta, NM 87042-8451
Mailing address
7 Wildwood LN
Peralta, NM 87042-8451
Phone (505) 585-1958
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
| License | State | Type | Specialty |
|---|---|---|---|
| CTB20250556 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755475200000",
"number": "1205713708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 WILDWOOD LN",
"city": "PERALTA",
"state": "NM",
"postal_code": "870428451",
"telephone_number": "505-585-1958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 WILDWOOD LN",
"city": "PERALTA",
"state": "NM",
"postal_code": "870428451",
"telephone_number": "505-585-1958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANKO",
"first_name": "REBECCA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-18",
"last_updated": "2025-08-18",
"certification_date": "2025-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "CTB20250556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peralta, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.