Stephanie Malouf

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CTB20240016 Issued in NM

Practice address

2055 S Pacheco St Ste 500
Santa Fe, NM 87505-3994

Phone

(505) 702-8112

NPI assigned

Sep 11, 2020

Last updated

Jan 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trail Ahead Therapy, LLC

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1235733437

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1558976076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 S PACHECO ST STE 500",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 S PACHECO ST STE 500",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053994",
            "telephone_number": "505-702-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOUF",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB20240016",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Makeev
• Jean-Philippe Malaty
• Alyshia Angel Maldonado
• Dimitri Yerik Maloney, CSW
• Paul Anthony Maloney, MSPT
• Mandala Medicine, LLC
• George Mandel, DOM
• Shiloh Dawn Mangino
• Marcella Manker
• Ashily A Mann

• Mental Health Counselor in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.