Individual provider Active NPI

Lynn A Hillas, LISW

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1396761847
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
I-04908 Issued in NM
Practice address
404 San Mateo Blvd NE
Suite 12
Albuquerque, NM 87108-5547
Phone
(505) 925-4052
Fax
(505) 925-4055
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 I-04908 NM Primary

Addresses

Primary practice location

404 San Mateo Blvd NE
Suite 12
Albuquerque, NM 87108-5547

Mailing address

1718 Anderson PL SE
Albuquerque, NM 87108-4406
Phone (505) 268-5633

Other identifiers 1

IdentifierTypeStateIssuer
36137511MedicaidNM

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
I-04908NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1396761847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 ANDERSON PL SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084406",
            "telephone_number": "505-268-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 SAN MATEO BLVD NE",
            "address_2": "SUITE 12",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085547",
            "telephone_number": "505-925-4052",
            "fax_number": "505-925-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLAS",
        "first_name": "LYNN",
        "middle_name": "A",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "I-04908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36137511",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.