Individual provider Active NPI

Nicole Maynez, LPC

  • Professional Counselor
  • El Paso, TX
National Provider Identifier
1578042396
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
76643 Issued in TX
Practice address
1600 Montana Ave
El Paso, TX 79902-5622
Phone
(915) 887-3410
Fax
(915) 351-3643
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 76643 TX
Professional Counselor 101YP2500X 76643 TX Primary

Addresses

Primary practice location

1600 Montana Ave
El Paso, TX 79902-5622

Mailing address

201 E Main Dr Ste 600
El Paso, TX 79901-1385
Phone (915) 887-3410

Other names 1

  • Nicole Otero Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
76643TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1578042396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MAIN DR STE 600",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799011385",
            "telephone_number": "915-887-3410",
            "fax_number": "915-351-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MONTANA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799025622",
            "telephone_number": "915-887-3410",
            "fax_number": "915-351-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNEZ",
        "first_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "76643",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "76643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "OTERO",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.