New Mexico Neurodiversity Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

NEW MEXICO NEURODIVERSITY CENTER

Practice address

3600 Cerrillos Rd Ste 724D
Santa Fe, NM 87507-2690

Phone

(575) 342-9178

Fax

(575) 252-4994

NPI assigned

Sep 30, 2026

Last updated

Oct 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jedediah Walls, LPCC-S, ATR-PNPI 1174272397

Title

Director

Phone

(575) 342-9178

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jedediah Walls, LMHC, ATR-P

  • Mental Health Counselor
  • Santa Fe, NM
  • NPI 1174272397
  Authorized official Same address or phone

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791504000000",
    "number": "1275447062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 CERRILLOS RD STE 724D",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875072690",
            "telephone_number": "575-342-9178",
            "fax_number": "575-252-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 CERRILLOS RD STE 724D",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875072690",
            "telephone_number": "575-342-9178",
            "fax_number": "575-252-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO NEURODIVERSITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "JEDEDIAH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "575-342-9178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPCC-S, ATR-P"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.