Child Counseling Center and Play Therapy Institute of New Mexico

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

CHILD COUNSELING CENTER AND PLAY THERAPY INSTITUTE OF NEW MEXICO

Practice address

1400 Maclovia St Ste 1
Santa Fe, NM 87505-3253

Phone

(505) 772-0459

NPI assigned

Jun 9, 2019

Organization subpart

No

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

Authorized official

Name

Susan Bienvenu, MA, LPCCNPI 1154713543

Title

Founder

Phone

(505) 316-1182

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Bienvenu, MA, LPC

  • Professional Counselor
  • Santa Fe, NM
  • NPI 1154713543
  NPD (past) Authorized official
• Katherine Somers Hall

  • Counselor
  • Santa Fe, NM
  • NPI 1851426134
  NPD
• Holly Elizabeth Shaw, PH.D., LPC

  • Mental Health Counselor
  • Santa Fe, NM
  • NPI 1699981274
  NPD

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1619536141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 JUNIPER DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011324",
            "telephone_number": "505-316-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MACLOVIA ST STE 1",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053253",
            "telephone_number": "505-772-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD COUNSELING CENTER AND PLAY THERAPY INSTITUTE OF NEW MEXICO",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "BIENVENU",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "505-316-1182",
        "authorized_official_credential": "MA, LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32055072",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.childcounselingcenterofnm.com",
            "affiliation": "N",
            "address_1": "1400 Maclovia St Ste 1",
            "city": "Santa Fe",
            "state": "NM",
            "country_code": "US",
            "postal_code": "875053253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.childcounselingcenterofnm.com",
            "affiliation": "N",
            "address_1": "1400 Maclovia St Ste 1",
            "city": "Santa Fe",
            "state": "NM",
            "country_code": "US",
            "postal_code": "875053253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kerrilyn Chew, D.O.M.
• Victoria Chew, DO
• Robert T Chiarito, DDS
• Miranda Chicklis, LMHC
• Nicholas David Chignoli, LMSW
• Josiah H Child, M.D.
• Children, Youth & Families Dept.-Protective Services
• Children'S Medical Services
• Children'S Medical Services
• Charnes Sy Chiu, MD

• Adolescent and Children Mental Health Clinic/Center in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Adolescent and Children Mental Health Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.