Active NPI
Ryan Mulnick
- Professional Counselor
- Taos, NM
National Provider Identifier
1518791003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 105 Bertha Rd Ste B
Taos, NM 87571-7148 - Phone
- (575) 758-4297
- NPI assigned
- Aug 28, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
105 Bertha Rd Ste B
Taos, NM 87571-7148
Mailing address
PO Box 330
Taos, NM 87571-0330
Phone (208) 315-3663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4600 Montgomery Blvd NE
Suite A105
Albuquerque, NM 87109-1200
PO Box
Taos, NM 87571
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Earth Spirit Awakenings LLC | Current | Accepting new patients |
Locations
1302 Calle de la Merced
Ste F
Espanola, NM 87532
Phone (505) 983-8225
4001 Office Court Dr
Ste 102
Santa Fe, NM 87507
Phone (505) 395-9437
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.
-
dba Mesa Vista Wellness
- Community/Behavioral Health Agency
- Santa Fe, NM
- NPI 1447490800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790121600000",
"number": "1518791003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 330",
"city": "TAOS",
"state": "NM",
"postal_code": "875710330",
"telephone_number": "208-315-3663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 BERTHA RD STE B",
"city": "TAOS",
"state": "NM",
"postal_code": "875717148",
"telephone_number": "575-758-4297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULNICK",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-28",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.