Active NPI
Exclusive Psychiatric Care LLC
- Psychiatric/Mental Health Nurse Practitioner
- Las Cruces, NM
National Provider Identifier
1609267103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- EXCLUSIVE PSYCHIATRIC CARE LLC
- Practice address
- 1161 Mall Dr
Ste C
Las Cruces, NM 88011-8193 - Phone
- (575) 522-2330
- Fax
- (575) 522-2344
- NPI assigned
- Feb 5, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Selene Mendoza, CNP
- Title
- Owner
- Phone
- (575) 522-2330
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
1161 Mall Dr
Ste C
Las Cruces, NM 88011-8193
Mailing address
1161 Mall Dr
Ste C
Las Cruces, NM 88011-8193
Phone (575) 522-2330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150512000295 | NM | Part B Supplier - Clinic/Group Practice | 0446579569 |
Receives reassigned benefits from 5 practitioners Practice locations: Las Cruces, NM |
National Provider Directory
National Provider DirectoryLocations
1161 Mall Dr
Ste C
Las Cruces, NM 88011
Phone (575) 522-2330
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Albuquerque, NM
- NPI 1609364249
NM, Psychiatric/Mental Health
-
- Professional Counselor
- Las Cruces, NM
- NPI 1275938094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423094400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1423094400000",
"number": "1609267103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1161 MALL DR",
"address_2": "STE C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880118193",
"telephone_number": "575-522-2330",
"fax_number": "575-522-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1161 MALL DR",
"address_2": "STE C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880118193",
"telephone_number": "575-522-2330",
"fax_number": "575-522-2344"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXCLUSIVE PSYCHIATRIC CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-05",
"last_updated": "2015-02-05",
"status": "A",
"authorized_official_last_name": "MENDOZA",
"authorized_official_first_name": "SELENE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "575-522-2330",
"authorized_official_credential": "CNP"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.