Individual provider Active NPI

Faith M Mahoney, LPCC LADAC

  • Professional Counselor
  • Las Cruces, NM
National Provider Identifier
1235208596
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CCMH0215331 Issued in NM
Practice address
535 S. Miranda St.
Las Cruces, NM 88005
Phone
(575) 647-2800
Fax
(575) 647-2898
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC1692 TN
Counselor 101Y00000X LDC928 TN
Professional Counselor 101YP2500X 1692 TN
Professional Counselor 101YP2500X CCMH0215331 NM Primary

Addresses

Primary practice location

535 S. Miranda St.
Las Cruces, NM 88005

Mailing address

385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Other practice location 1

109 West Watauga Avenue
Johnson City, TN 37605
Phone (423) 232-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: No
  • 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
I20240223000529 NM Practitioner - Mental Health Counselor 6608210166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

385 Calle de Alegra
Suite a
Las Cruces, NM 88005-3417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LDC928TNMDCounselor
LPC1692TNMDCounselor
1692TNMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de Familia, Incorporated CurrentSince Feb 8, 2024 Accepting new patients
La Clinica de Familia, Incorporated CurrentSince Feb 8, 2024 Accepting new patients
La Clinica de Familia, Incorporated Current Accepting new patients

Locations

826 Anthony Dr
Anthony, NM 88021
Phone (575) 201-5135

385 Calle de Alegra
Bldg A
Las Cruces, NM 88005
Phone 57552611052444

760 N Motel Blvd
Ste Ac
Las Cruces, NM 88007

535 S Miranda St
Las Cruces, NM 88005

Organizations & group practices 3

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1235208596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S. MIRANDA ST.",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88005",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 West Watauga Avenue",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37605",
            "country_code": "US",
            "telephone_number": "423-232-2600",
            "fax_number": "423-232-2646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "FAITH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LPCC LADAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-05-06",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "LPC1692",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "LDC928",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "1692",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0215331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.