Individual provider Active NPI

Cynthia League, LMHC

  • Mental Health Counselor
  • Las Cruces, NM
National Provider Identifier
1407215411
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0180461 Issued in NM
Practice address
100 W Griggs Ave
Las Cruces, NM 88001
Phone
(575) 647-2800
Fax
(575) 647-2898
NPI assigned
Feb 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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 0180461 NM Primary

Addresses

Primary practice location

100 W Griggs Ave
Las Cruces, NM 88001

Mailing address

385 Calle de Alegra
BLDG. a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Other identifiers 1

IdentifierTypeStateIssuer
11508507MedicaidNM

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
I20240430003025 NM Practitioner - Mental Health Counselor 1153761770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jared J. Gonzales LLCGroup PAC ID 6709254386, 5 clinicians

Practice addresses (Care Compare)

1395 Missouri Ave
Las Cruces, NM 88001-5327
Phone (575) 522-5466

1505 S Don Roser Dr
Suite a
Las Cruces, NM 88011-4596
Phone (575) 680-0682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0180461NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de Familia, Incorporated CurrentSince Apr 23, 2024 Accepting new patients
Jared J. Gonzales LLC CurrentSince Nov 22, 2024 Accepting new patients
La Clinica de Familia, Incorporated Current Accepting new patients
La Clinica de Familia, Incorporated CurrentSince Apr 23, 2024 Accepting new patients

Locations

826 Anthony Dr
Anthony, NM 88021
Phone (575) 201-5135

535 S Miranda St
Las Cruces, NM 88005

1395 Missouri Ave
Las Cruces, NM 88001
Phone (505) 522-5466

760 N Motel Blvd
Ste Ac
Las Cruces, NM 88007

385 Calle de Alegra
Bldg A
Las Cruces, NM 88005
Phone 57552611052444

100 W Griggs Ave
Las Cruces, NM 88001
Phone (505) 647-2800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1407215411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA",
            "address_2": "BLDG. A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W GRIGGS AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88001",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAGUE",
        "first_name": "CYNTHIA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-18",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0180461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11508507",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.