Keli Maureen Dersch-Baldonado, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

T-0099941 Issued in NM

Practice address

12124 State Highway 14 N
Cedar Crest, NM 87008-9313

Phone

(505) 250-8119

Fax

(505) 281-3557

NPI assigned

Apr 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Focus on Healing, P.C.

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1477321990
  NPD Authorized official

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639291230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12124 STATE HIGHWAY 14 N",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870089313",
            "telephone_number": "505-250-8119",
            "fax_number": "505-281-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12124 STATE HIGHWAY 14 N",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870089313",
            "telephone_number": "505-250-8119",
            "fax_number": "505-281-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERSCH-BALDONADO",
        "first_name": "KELI",
        "middle_name": "MAUREEN",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "T-0099941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Cedar Crest, NM
• Providers in Cedar Crest, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.