Southeast Mental Health Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

0426 Issued in CO

Legal business name

SOUTHEAST MENTAL HEALTH SERVICES

Practice address

711 Barnes Ave
La Junta, CO 81050-2138

Phone

(719) 384-5446

Fax

(719) 384-5672

NPI assigned

Oct 6, 2005

Organization subpart

No

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

Authorized official

Name

Lisa Chavez

Title

Contract & Credentialing Manager

Phone

(719) 383-5448

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1417945254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 BARNES AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502138",
            "telephone_number": "719-384-5446",
            "fax_number": "719-384-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 BARNES AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502138",
            "telephone_number": "719-384-5446",
            "fax_number": "719-384-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CONTRACT & CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-383-5448"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CO",
            "license": "0426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CAPITATION PROGR",
            "identifier": "4034013",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4160099",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody Elizabeth Sniff, LPC
• Kimberly Dawn Snyder, LPC
• Jose Soto
• Southeast Mental Health Services
• Southeast Mental Health Services
• Southeast Mental Health Services
• Southeast Mental Health Services
• Southeast Mental Health Services
• Angela Stafford, M.S. CCC-SLP
• State of Colorado (Otero Junior College Child Development Services)

• Mental Health Clinic/Center (Including Community Mental Health Center) in La Junta, CO
• Providers in La Junta, CO by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.