Individual provider Active NPI

Omar A Vega, LPCC, LED, LSP

  • Professional Counselor
  • Santa Fe, NM
National Provider Identifier
1386855252
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0123991 Issued in NM
Practice address
29 Rito Guicu
Santa Fe, NM 87507-4321
Phone
(505) 235-4002
Fax
(505) 473-9409
NPI assigned
May 24, 2007
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 123991 NM
Professional Counselor 101YP2500X 0123991 NM Primary
School Psychologist 103TS0200X 375345 NM

Addresses

Primary practice location

29 Rito Guicu
Santa Fe, NM 87507-4321

Mailing address

29 Rito Guicu
Santa Fe, NM 87507-4321
Phone (505) 235-4002

Other identifiers 1

IdentifierTypeStateIssuer
64972526MedicaidNM

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
I20240313003146 NM Practitioner - Mental Health Counselor 1557752987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2504 Camino Entrada
Santa Fe, NM 87507-4851
Phone (505) 216-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123991NMMDProfessional Counselor
375345NMMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Teambuilders Behavioral Health, LLC CurrentSince Jan 28, 2024 Accepting new patients
Teambuilders Behavioral Health, LLC CurrentSince Jan 28, 2024 Accepting new patients
Teambuilders Behavioral Health, LLC Professional Current Accepting new patients
Vega Diagnostic & Consulting Services, LLC Professional PastSince Jul 24, 2022 Accepting new patients

Locations

428 Los Lentes Rd SE
Ste 3
Los Lunas, NM 87031
Phone (505) 216-2727

2504 Camino Entrada
Santa Fe, NM 87507
Phone (505) 216-2727

105 Paseo del Canon W
Taos, NM 87571
Phone (575) 751-7037

Organizations & group practices 4

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1386855252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 RITO GUICU",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074321",
            "telephone_number": "505-235-4002",
            "fax_number": "505-473-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 RITO GUICU",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074321",
            "telephone_number": "505-235-4002",
            "fax_number": "505-473-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "OMAR",
        "middle_name": "A",
        "credential": "LPCC, LED, LSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "123991",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0123991",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NM",
            "license": "375345",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64972526",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.