Individual provider Active NPI

Micah Merriman

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1427413236
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
T0178291 Issued in NM
Practice address
1025 Hermosa Dr SE
Albuquerque, NM 87108-4312
Phone
(505) 237-0061
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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 T0178291 NM Primary

Addresses

Primary practice location

1025 Hermosa Dr SE
Albuquerque, NM 87108-4312

Mailing address

620 Burma Dr NE
Albuquerque, NM 87123-1409
Phone (505) 239-9235

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
T0178291NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1427413236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BURMA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871231409",
            "telephone_number": "505-239-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 HERMOSA DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084312",
            "telephone_number": "505-237-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIMAN",
        "first_name": "MICAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T0178291",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 21, 2015; 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.