Individual provider Active NPI

Andrea Taylor, LPCC

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1558996751
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CTB-2024-0446 Issued in NM
Practice address
718 Central Ave SW
Albuquerque, NM 87102-3008
Phone
(505) 453-4304
NPI assigned
Mar 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CTB-2024-0446 NM Primary

Addresses

Primary practice location

718 Central Ave SW
Albuquerque, NM 87102-3008

Mailing address

718 Central Ave SW
Albuquerque, NM 87102-3008
Phone (505) 453-4303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829001845 NM Practitioner - Mental Health Counselor 8921547316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CTB-2024-0446NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stay the Course Counseling CurrentSince Aug 1, 2024 Accepting new patients

Locations

718 Central Ave SW
Albuquerque, NM 87102
Phone (505) 453-4304

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.

NPI Registry JSON

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

{
    "created_epoch": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1558996751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 CENTRAL AVE SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023008",
            "telephone_number": "505-453-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 CENTRAL AVE SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023008",
            "telephone_number": "505-453-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ANDREA",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-08",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2024-0446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.