Organization Active NPI

Second Creation Inc.

  • Mental Health Counselor
  • Santa Fe, NM
National Provider Identifier
1497120422
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0161941 Issued in NM
Legal business name
SECOND CREATION INC.
Practice address
1800 Old Pecos TRL Ste P
Santa Fe, NM 87505-4759
Phone
(505) 795-8447
Fax
(505) 213-0337
NPI assigned
Dec 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Ms. Alexandra E Pitt, LPCCNPI 1578793550
Title
Ceo
Phone
(505) 795-8447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 0161941 NM Primary

Addresses

Primary practice location

1800 Old Pecos TRL Ste P
Santa Fe, NM 87505-4759

Mailing address

1800 Old Pecos TRL Ste P
Santa Fe, NM 87505-4759
Phone (505) 795-8447

Other identifiers 1

IdentifierTypeStateIssuer
22027718MedicaidNM

National Provider Directory

National Provider Directory

Locations

1421 Luisa St
Ste O
Santa Fe, NM 87505
Phone (505) 428-9086

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1497120422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 OLD PECOS TRL STE P",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054759",
            "telephone_number": "505-795-8447",
            "fax_number": "505-213-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 OLD PECOS TRL STE P",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054759",
            "telephone_number": "505-795-8447",
            "fax_number": "505-213-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CREATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "PITT",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-795-8447",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0161941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22027718",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.