Robert Winthrop Deane, LPCC
Individual provider Active NPI Mental Health Counselor · Santa Fe, NM
NPI 1508912650 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508912650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 0077991 (NM)
- Practice address
- 2871 Clark CT
Santa Fe, NM 87507-5179 - Phone
- (505) 670-3202
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Las Clinicas del Norte, Incorporated
Practice addresses (Care Compare)
P O Box
El Rito, NM 87530-0237
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240426000022 | NM | Practitioner - Mental Health Counselor | 9436509783 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0077991 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Las Clinicas del Norte, Incorporated | Current |
Accepting new patients | |
| Las Clinicas del Norte Incorporated | Current |
Accepting new patients |
Locations
1183 Diamond Dr
Ste D
Los Alamos, NM 87544
Phone (505) 303-0400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0077991 | NM | Yes |
Addresses
Primary practice location
2871 Clark CT
Santa Fe, NM 87507-5179
Mailing address
2442 Cerrillos Rd
PMB 268
Santa Fe, NM 87505-3262
Phone (505) 670-3202
NPI Registry JSON
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508912650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2442 CERRILLOS RD",
"address_2": "PMB 268",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875053262",
"telephone_number": "505-670-3202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2871 CLARK CT",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875075179",
"telephone_number": "505-670-3202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEANE",
"first_name": "ROBERT",
"middle_name": "WINTHROP",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0077991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
- Jesus De Los Santos
- Darlene Judith De Paz Corado
- Paul Mario De Stefano
- Dana M Dean
- Renee K. Dean
- Oliva Dearmond
- Jayne A Dearth
- Debbie a. Vigil MD Inc
- Jordy Debenning
- Michael Debernardi
All providers in Santa Fe, NM · Mental Health Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.