Individual provider Active NPI

Michael H Kershaw, ED.S.

  • School Psychologist
  • Las Cruces, NM
National Provider Identifier
1336472562
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
1990 E Lohman Ave
Ste. 208
Las Cruces, NM 88001-3172
Phone
(575) 993-5720
Fax
(575) 521-9215
NPI assigned
Sep 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0139761 NM
School Psychologist 103TS0200X Primary

Addresses

Primary practice location

1990 E Lohman Ave
Ste. 208
Las Cruces, NM 88001-3172

Mailing address

1990 E Lohman Ave Ste 208
Las Cruces, NM 88001-3172
Phone (575) 993-5720

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241003000318 NM Practitioner - Mental Health Counselor 0143672519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1990 E Lohman Ave
Suite 223
Las Cruces, NM 88001-3172
Phone (575) 993-5720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0139761NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Treatment Associates, Inc. Mental Health CurrentSince Jan 1, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1336472562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 E LOHMAN AVE STE 208",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013172",
            "telephone_number": "575-993-5720",
            "fax_number": "575-521-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 E LOHMAN AVE",
            "address_2": "STE. 208",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013172",
            "telephone_number": "575-993-5720",
            "fax_number": "575-521-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHAW",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "credential": "ED.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-04",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0139761",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.