NPIMap

Individual provider Active NPI

Tessa Lucero

  • Professional Counselor
  • Rio Rancho, NM
National Provider Identifier
1487028833
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CCMH0196601 Issued in NM
Practice address
2441 Cabezon Blvd SE
Rio Rancho, NM 87124
Phone
(505) 717-1155
Fax
(505) 717-1473
NPI assigned
Nov 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X CCMH0196601 NM Primary

Addresses

Primary practice location

2441 Cabezon Blvd SE
Rio Rancho, NM 87124

Mailing address

2441 Cabezon Blvd SE
Rio Rancho, NM 87124-1515
Phone (505) 717-1155

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
CCMH0196601NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Connection LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1487028833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 CABEZON BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241515",
            "telephone_number": "505-717-1155",
            "fax_number": "505-717-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 CABEZON BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "87124",
            "telephone_number": "505-717-1155",
            "fax_number": "505-717-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "TESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0196601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.