La Luz Provider Agency LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

LA LUZ PROVIDER AGENCY LLC

Practice address

501 Franklin Ave Unit 6
Santa Fe, NM 87501-3617

Phone

(505) 660-3484

NPI assigned

Mar 22, 2016

Organization subpart

No

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

Authorized official

Name

Cheryl Sciacca, LPCCNPI 1366693038

Title

Co-Owner

Phone

(505) 660-3484

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cheryl Sciacca, MA, LPCC

  • Mental Health Counselor
  • Santa Fe, NM
  • NPI 1366693038
  Medicare reassignment Care Compare group NPD Authorized official
• Cynthia G Rank Ballas, MA LPC

  • Mental Health Counselor
  • Las Vegas, NM
  • NPI 1043436538
  Medicare reassignment Care Compare group NPD
• Annie King, LPAT

  • Art Therapist
  • Santa Fe, NM
  • NPI 1124889894
  NPD

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1245692102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34091",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875944091",
            "telephone_number": "505-660-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FRANKLIN AVE UNIT 6",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875013617",
            "telephone_number": "505-660-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA LUZ PROVIDER AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "SCIACCA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "505-660-3484",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96838272",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cassondra Richelle La Fond
• Megan Sophie La Rose, MS, RD, CNSC
• La Vida Hermosa Inc
• La Vida Hermosa, Inc.
• Laboratory Corporation of America
• Labyrinth LLC

• Specialist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.