Active NPI
Miriam Juarez, MA
- Addiction (Substance Use Disorder) Counselor
- Las Cruces, NM
National Provider Identifier
1245656966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 304 W Griggs Ave
Las Cruces, NM 88005-2603 - Phone
- (575) 405-7146
- Fax
- (575) 405-5446
- NPI assigned
- Mar 6, 2014
- Last updated
- Oct 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NU | Primary | |
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
304 W Griggs Ave
Las Cruces, NM 88005-2603
Mailing address
304 W Griggs Ave Ste C
Las Cruces, NM 88005-2603
Phone (575) 405-7146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18677037 | Medicaid | NM |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vaillancourt Associates LLC Dba Alameda Marriage and Family Therapy | Current | Accepting new patients |
Locations
304 W Griggs Ave
Ste C
Las Cruces, NM 88005
Phone (575) 405-7146
619 N Alameda Blvd
Las Cruces, NM 88005
Phone (575) 386-0670
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Marriage & Family Therapist
- Las Cruces, NM
- NPI 1063859015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1245656966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 W GRIGGS AVE STE C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880052603",
"telephone_number": "575-405-7146",
"fax_number": "575-405-5446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 W GRIGGS AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880052603",
"telephone_number": "575-405-7146",
"fax_number": "575-405-5446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUAREZ",
"first_name": "MIRIAM",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-06",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "18677037",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.