Active NPI
Cassandra M Carrillo, LCSW
- Rehabilitation Counselor
- Roswell, NM
National Provider Identifier
1497258362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- License
- C-09035
- Practice address
- 1107 S Atkinson Ave
Roswell, NM 88203-7154 - Phone
- (575) 578-4826
- NPI assigned
- Mar 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | C-09035 | NM | Primary |
Addresses
Primary practice location
1107 S Atkinson Ave
Roswell, NM 88203-7154
Mailing address
1107 S Atkinson Ave
Roswell, NM 88203-7154
Phone (575) 578-4826
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
| License | State | Type | Specialty |
|---|---|---|---|
| C-09035 | NM | MD | Rehabilitation Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recovery Services of New Mexico, LLC | Past | Accepting new patients | |
| Recovery Services of New Mexico, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1861848632
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521158400000",
"number": "1497258362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 S ATKINSON AVE",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882037154",
"telephone_number": "575-578-4826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 S ATKINSON AVE",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882037154",
"telephone_number": "575-578-4826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "CASSANDRA",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-16",
"last_updated": "2018-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "NM",
"license": "C-09035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.