Meredith Baca, LPCC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CCMH200151 Issued in NM

Practice address

360 Fog Road
Espanola, NM 87532

Phone

(210) 862-1037

NPI assigned

Nov 17, 2014

Last updated

Nov 9, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elevation Counseling, LLC

  • Psychiatric/Mental Health Registered Nurse
  • Albuquerque, NM
  • NPI 1831514520
  Medicare reassignment NPD
• Santa Clara Pueblo

  • Counselor
  • Espanola, NM
  • NPI 1407147994
  NPD (past)

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1306242474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1045",
            "city": "OHKAY OWINGEH",
            "state": "NM",
            "postal_code": "875661045",
            "telephone_number": "210-593-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 FOG ROAD",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "87532",
            "telephone_number": "210-862-1037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9503 Powhatan Dr Apt 404",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782303119",
            "country_code": "US",
            "telephone_number": "210-593-8552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACA",
        "first_name": "MEREDITH",
        "credential": "LPCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "68716",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CCMH200151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne K Auge II, M.D.
• Ayudantes
• Ayudantes Inc
• Bernadine Baca
• Celeste Baca, LMSW
• Suho Bae, DDS
• Ida Baldonado
• Yevgeni Balicek
• Vianey Barajas, CCSS
• Victoria Baros

• Mental Health Counselor in Espanola, NM
• Providers in Espanola, 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 Nov 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.