Jonathan Wallach, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0181511 Issued in NM

Practice address

2019 Galisteo St
Suite E2
Santa Fe, NM 87505-2143

Phone

(505) 983-8225

NPI assigned

Jun 9, 2016

Last updated

Jun 9, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jonathan Wallach LPCC LLC

  • Mental Health Counselor
  • Santa Fe, NM
  • NPI 1235014044
  Medicare reassignment NPD
• Mesa Vista Wellness

  • Community/Behavioral Health Agency
  • Santa Fe, NM
  • NPI 1649629114
  Authorized official Same address or phone

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1568811537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST",
            "address_2": "SUITE E2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052143",
            "telephone_number": "505-983-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST",
            "address_2": "SUITE E2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052143",
            "telephone_number": "505-983-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "JONATHAN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0181511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braden Jacob Wallace, PHARMD
• Helen Timmie Wallace, PT
• Josephine Wallace
• Kenyan Wallace, LMT
• Tiffani Wallace
• Elizabeth Wallen, MD
• Jedediah Walls, LMHC, ATR-P
• Walmart
• Erin Walsh, PHARMD
• Kris-Ann Walters, LMHC

• 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 Jun 9, 2016; 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.

Verify at the official NPI Registry.