Individual provider Active NPI

Michael Richards

  • Professional Counselor
  • Titusville, FL
National Provider Identifier
1447872726
Registry record updated Mar 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
NMLPCC0190521 Issued in NM
Practice address
3091 Sir Hamilton Cir
Titusville, FL 32780-4959
Phone
(321) 593-0926
NPI assigned
May 10, 2020
Last updated
Mar 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NMLPCC0190521 NM Primary

Addresses

Primary practice location

3091 Sir Hamilton Cir
Titusville, FL 32780-4959

Mailing address

5400 Gibson Blvd SE
Albuquerque, NM 87108-5566
Phone (407) 690-9412

Other practice location 1

5400 Gibson Blvd SE
Albuquerque, NM 87108-5566
Phone (505) 254-4500

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
I20250404002780 NM Practitioner - Mental Health Counselor 9133643703 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NMLPCC0190521NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Behavioral Services of Albuquerque, LLC CurrentSince Mar 31, 2025 Accepting new patients

Locations

5400 Gibson Blvd SE
Albuquerque, NM 87108
Phone (505) 262-7174

5400 Gibson Blvd SE
Ste 4
Albuquerque, NM 87108
Phone (505) 254-4500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1589068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742601600000",
    "number": "1447872726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 GIBSON BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085566",
            "telephone_number": "407-690-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3091 SIR HAMILTON CIR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327804959",
            "telephone_number": "321-593-0926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Gibson Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871085566",
            "country_code": "US",
            "telephone_number": "505-254-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-10",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "NMLPCC0190521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.