Mary Sue Blackhurst, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0080161 Issued in NM

Practice address

110 E Mescalero Rd
Roswell, NM 88201-6542

Phone

(575) 755-2272

Fax

(575) 622-3325

NPI assigned

Nov 10, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417938952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E MESCALERO RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88201",
            "telephone_number": "575-755-2272",
            "fax_number": "575-622-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MESCALERO RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016542",
            "telephone_number": "575-755-2272",
            "fax_number": "575-622-3325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "914 N Canal St",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "NM",
            "postal_code": "882205110",
            "country_code": "US",
            "telephone_number": "505-885-4836",
            "fax_number": "505-887-9579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKHURST",
        "first_name": "MARY",
        "middle_name": "SUE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0080161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9057051",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jay R Bishop, D.O.
• Katherine Archuleta Bishop, M.S. CCC-SLP
• Helen Black, LMSW
• Levi Colter Black, CRNA
• Steven R Black, M.D.
• Deborah Blessing, MOTR
• Jana L Blewett, M.S. CCC-SLP
• Claire Blount
• Blue Horseshoe, Inc. (Advanced Medical Supply)
• Blue Horseshoe, Inc. (Advanced Home Care and Medical Supply)

• Mental Health Counselor in Roswell, NM
• Providers in Roswell, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.