Individual provider Active NPI

Thomas Anthony Trujillo, LMSW

  • Mental Health Counselor
  • Rio Rancho, NM
National Provider Identifier
1386395598
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
M-10965 Issued in NM
Practice address
4011 Barbara Loop SE Ste 103
Rio Rancho, NM 87124-1040
Phone
(505) 715-4322
NPI assigned
Jan 11, 2022
Last updated
Jan 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X M-10965 NM Primary

Addresses

Primary practice location

4011 Barbara Loop SE Ste 103
Rio Rancho, NM 87124-1040

Mailing address

4011 Barbara Loop SE Ste 103
Rio Rancho, NM 87124-1040
Phone (505) 715-4322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M-10965NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Paths Counseling LLC CurrentSince Jan 21, 2022 Accepting new patients

Locations

4011 Barbara Loop SE
Ste 103
Rio Rancho, NM 87124
Phone (505) 249-9347

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1386395598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 BARBARA LOOP SE STE 103",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241040",
            "telephone_number": "505-715-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 BARBARA LOOP SE STE 103",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241040",
            "telephone_number": "505-715-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "THOMAS",
        "middle_name": "ANTHONY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "M-10965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.