Mary Ellen Agolia, PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1188 Issued in NM

Practice address

20 Cottage Row
Unit B
High Rolls Mountain Park, NM 88325-9010

Phone

(575) 430-4115

Fax

(866) 561-1508

NPI assigned

Nov 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616284800000",
    "number": "1598837841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 351",
            "city": "HIGH ROLLS MOUNTAIN PARK",
            "state": "NM",
            "postal_code": "883250351",
            "telephone_number": "575-430-4115",
            "fax_number": "866-561-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 COTTAGE ROW",
            "address_2": "UNIT B",
            "city": "HIGH ROLLS MOUNTAIN PARK",
            "state": "NM",
            "postal_code": "883259010",
            "telephone_number": "575-430-4115",
            "fax_number": "866-561-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOLIA",
        "first_name": "MARY ELLEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "1188",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M0432",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N3745",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole E Golly
• Melinda Poteet Green, NBCOT, COTA
• Clifford Eugene Hughes, CRNA
• Nancy Lynn Laney, MPH
• McClain Counseling Services, LLC

• Mental Health Counselor in High Rolls Mountain Park, NM
• Providers in High Rolls Mountain Park, 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 Mar 21, 2021; 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.