Individual provider Active NPI

Andres Miguel Duran, LPCC

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1356776538
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CCMH0183121 Issued in NM
Practice address
7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314
Phone
(505) 884-1114
NPI assigned
Sep 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 CCMH0183121 NM Primary

Addresses

Primary practice location

7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314

Mailing address

6908 Astair Ave NW
Albuquerque, NM 87120-4422

Other identifiers 1

IdentifierTypeStateIssuer
76580032MedicaidNM

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL www.sageclinic.org Other
Other URL Work Direct

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
I20240307001664 NM Practitioner - Mental Health Counselor 3577911981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Engage and Ignite CounselingGroup PAC ID 9830534213, 4 clinicians

Practice addresses (Care Compare)

6303 4TH St NW
Suite 1
Los Ranchos, NM 87107-5855
Phone (505) 903-4413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CCMH0183121NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Engage and Ignite Counseling CurrentSince Jan 1, 2024 Accepting new patients

Locations

6303 4th St NW
Ste 1
Los Ranchos, NM 87107
Phone (505) 321-0906

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": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1356776538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6908 ASTAIR AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 JEFFERSON ST NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094314",
            "telephone_number": "505-884-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "ANDRES",
        "middle_name": "MIGUEL",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-06",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0183121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76580032",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.sageclinic.org",
            "affiliation": "N",
            "endpointDescription": "Sage Neuroscience Center",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "7850 Jefferson St NE Ste 300",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871094314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Work",
            "affiliation": "N",
            "endpointDescription": "Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "7850 Jefferson St NE Ste 300",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871094314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.