NPIMap

Organization Active NPI

Earth Spirit Awakenings

  • Mental Health Counselor
  • Santa Fe, NM
National Provider Identifier
1285086769
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1600129265 Issued in NM
Legal business name
EARTH SPIRIT AWAKENINGS
Practice address
2019 Galisteo St
Santa Fe, NM 87505-2143
Phone
(505) 983-8225
Fax
(505) 930-5427
NPI assigned
Jul 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Authorized official

Name
Tod Dicecco, LPCCNPI 1225230097
Title
Executive Director
Phone
(505) 983-8225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 1600129265 NM Primary

Addresses

Primary practice location

2019 Galisteo St
Santa Fe, NM 87505-2143

Mailing address

2019 Galisteo St
Santa Fe, NM 87505-2143
Phone (505) 983-8225

Other names 1

  • dba Mesa Vista Wellness Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dba Mesa Vista Wellness2 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 1

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": "1467849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467849600000",
    "number": "1285086769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052143",
            "telephone_number": "505-983-8225",
            "fax_number": "505-930-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052143",
            "telephone_number": "505-983-8225",
            "fax_number": "505-930-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTH SPIRIT AWAKENINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-07-07",
        "status": "A",
        "authorized_official_last_name": "DICECCO",
        "authorized_official_first_name": "TOD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-983-8225",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "1600129265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Mesa Vista Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.