David William Maestas, LADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1028971 Issued in NM

Practice address

2520 Virginia St NE
Ste 200
Albuquerque, NM 87110-4689

Phone

(505) 296-4449

Fax

(505) 296-0497

NPI assigned

Aug 4, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. David William Maestas Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lighthouse Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Albuquerque, NM
  • NPI 1992866313
  NPD (past)

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

{
    "created_epoch": "1344038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344038400000",
    "number": "1225385685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 MCKNIGHT AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021238",
            "telephone_number": "505-304-7420",
            "fax_number": "505-200-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 VIRGINIA ST NE",
            "address_2": "STE 200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104689",
            "telephone_number": "505-296-4449",
            "fax_number": "505-296-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAESTAS",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "credential": "LADAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-04",
        "last_updated": "2012-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "1028971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "MAESTAS",
            "middle_name": "WILLIAM",
            "prefix": "MR.",
            "credential": "CADAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gerald Phil Maese, DDS
• Aaron Maestas, CPSW
• Amelia Maestas, CNM
• Antonio Maestas
• Bradley Maestas
• Deanna V. Maestas, BCBA
• Denise Maestas
• Diane C Maestas, RD
• Diondra A Maestas, MS, CCC-SLP
• Erika Maestas, M.D.

• Addiction (Substance Use Disorder) Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2012; 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.