Active NPI
Gabrielle H Edidin, LCSW
- Mental Health Counselor
- Albuquerque, NM
National Provider Identifier
1417609058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- SW-2026-0324
- Practice address
- 516 11TH St NW
Albuquerque, NM 87102-1898 - Phone
- (505) 690-4097
- NPI assigned
- Jan 25, 2022
- Last updated
- Apr 3, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SW-2026-0324 | NM | Primary |
Addresses
Primary practice location
516 11TH St NW
Albuquerque, NM 87102-1898
Mailing address
9007 Washington St NE
Albuquerque, NM 87113-2722
Phone (505) 690-4097
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15492053 | Other | NM | CAQH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW-2026-0324 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umoja Behavioral Health PC | Current | Accepting new patients | |
| Essential Mental Health, LLC | Clinical | Current | Accepting new patients |
| Rooted Wellness Collective, LLC | Clinical | Current | Accepting new patients |
Locations
3150 Carlisle Blvd NE
Ste 105
Albuquerque, NM 87110
Phone (505) 410-1379
3150 Carlisle Blvd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 633-8173
Organizations & group practices 3
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.
-
- Clinical Social Worker
- Albuquerque, NM
- NPI 1447184296
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1134442270
Clinical
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Albuquerque, NM
- NPI 1063989648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1417609058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9007 WASHINGTON ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871132722",
"telephone_number": "505-690-4097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 11TH ST NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871021898",
"telephone_number": "505-690-4097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDIDIN",
"first_name": "GABRIELLE",
"middle_name": "H",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-25",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "SW-2026-0324",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "15492053",
"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 Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.