Individual provider Active NPI

Angela Sheridan, COUNSELOR

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1336816164
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CTB-2026-0156 Issued in NM
Practice address
12836 Lomas Blvd NE Ste C
Albuquerque, NM 87112-6200
Phone
(505) 595-7149
NPI assigned
Aug 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CTB-2026-0156 NM Primary

Addresses

Primary practice location

12836 Lomas Blvd NE Ste C
Albuquerque, NM 87112-6200

Mailing address

12836 Lomas Blvd NE Ste C
Albuquerque, NM 87112-6200
Phone (505) 595-7149

Other practice location 1

500 Marquette Ave NW Ste 1200
Albuquerque, NM 87102-5312
Phone (505) 218-7050

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
I20260508001344 NM Practitioner - Mental Health Counselor 0648748509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12836 Lomas Blvd NE C
Albuquerque, NM 87112-6210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CTB-2026-0156NMMDProfessional Counselor

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": "1630108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1336816164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12836 LOMAS BLVD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871126200",
            "telephone_number": "505-595-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12836 LOMAS BLVD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871126200",
            "telephone_number": "505-595-7149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Marquette Ave NW Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871025312",
            "country_code": "US",
            "telephone_number": "505-218-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "ANGELA",
        "credential": "COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-28",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CTB-2026-0156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.