NPIMap

Organization Active NPI

North Star Psychiatric Services LLC

  • Psychologist
  • Los Alamos, NM
National Provider Identifier
1245945716
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
NORTH STAR PSYCHIATRIC SERVICES LLC
Practice address
195 East Road Suite 104
Los Alamos, NM 87544-4301
Phone
(505) 412-7756
Fax
(505) 662-8859
NPI assigned
Jan 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
Susan R Morales
Title
Business Manager
Phone
(505) 663-6220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

195 East Road Suite 104
Los Alamos, NM 87544-4301

Mailing address

North Star Psychiatric Services LLC
195 East Road Suite 104
Los Alamos, NM 87544-4301
Phone (505) 412-7756

Other identifiers 1

IdentifierTypeStateIssuer
067620752MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
North Star Psychiatric Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1245945716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTH STAR PSYCHIATRIC SERVICES LLC",
            "address_2": "195 EAST ROAD SUITE 104",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875444301",
            "telephone_number": "505-412-7756",
            "fax_number": "505-662-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 EAST ROAD SUITE 104",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875444301",
            "telephone_number": "505-412-7756",
            "fax_number": "505-662-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "505-663-6220"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067620752",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.