Individual provider Active NPI

Amanda Gallegos, LMHC

  • Mental Health Counselor
  • Taos, NM
National Provider Identifier
1366711889
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
155811 Issued in NM
Practice address
1331 Gusdorf Rd
Taos, NM 87571-6282
Phone
(575) 758-3601
Fax
(575) 758-1058
NPI assigned
Dec 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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 T0143261 NM
Mental Health Counselor 101YM0800X 155811 NM Primary

Addresses

Primary practice location

1331 Gusdorf Rd
Taos, NM 87571-6282

Mailing address

PO Box 158
Espanola, NM 87532-0158
Phone (505) 753-7218

Other practice location 1

750 Morris Rd SE
Los Lunas, NM 87031-5242
Phone (505) 866-2318

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
I20240325002432 NM Practitioner - Mental Health Counselor 0941534747 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
155811NMMDMental Health Counselor
T0143261NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lozen & Company, LLC Mental Health CurrentSince Dec 17, 2024 Accepting new patients
Merced-LLC Merced Counseling Services Mental Health CurrentSince Jan 21, 2024 Accepting new patients

Organizations & group practices 2

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": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1366711889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875320158",
            "telephone_number": "505-753-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 GUSDORF RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716282",
            "telephone_number": "575-758-3601",
            "fax_number": "575-758-1058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Morris Rd SE",
            "address_purpose": "LOCATION",
            "city": "Los Lunas",
            "state": "NM",
            "postal_code": "870315242",
            "country_code": "US",
            "telephone_number": "505-866-2318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "AMANDA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T0143261",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "155811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

Verify at the official NPI Registry.