Individual provider Active NPI

Sherwin Keith Price, LPCC

  • Counselor
  • Albuquerque, NM
National Provider Identifier
1255636585
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
801 Encino PL NE
Albuquerque, NM 87102-2612
Phone
(505) 272-2573
NPI assigned
Jan 18, 2011
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 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 0164601 NM
Counselor 101Y00000X NM Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CCMH0184991 NM
Mental Health Counselor 101YM0800X CCMH0184991 NM

Addresses

Primary practice location

801 Encino PL NE
Albuquerque, NM 87102-2612

Mailing address

2441 Cabezon Blvd SE
Rio Rancho, NM 87124
Phone (505) 717-1155

Other identifiers 1

IdentifierTypeStateIssuer
56353081MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0164601NMMDCounselor
CCMH0184991NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Connection LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1255636585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 CABEZON BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "87124",
            "telephone_number": "505-717-1155",
            "fax_number": "505-717-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 ENCINO PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022612",
            "telephone_number": "505-272-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "SHERWIN",
        "middle_name": "KEITH",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-18",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NM",
            "license": "0164601",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NM",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CCMH0184991",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CCMH0184991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56353081",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.