Active NPI
Robert J Louis II, M.A.
- Mental Health Counselor
- Gallup, NM
National Provider Identifier
1639385339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0118711
- Practice address
- 310 E Mesa Ave
Gallup, NM 87301-6147 - Phone
- (505) 979-6102
- Fax
- (505) 863-6103
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0118711 | NM | Primary |
Addresses
Primary practice location
310 E Mesa Ave
Gallup, NM 87301-6147
Mailing address
503 Burke Dr
Gallup, NM 87301-5461
Phone (505) 979-6102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19683537 | Medicaid | NM |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250606000624 | NM | Practitioner - Mental Health Counselor | 0648780932 | Practice locations: Gallup, NM |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
300 W Hill Ave
Gallup, NM 87301-6364
Phone (505) 979-6102
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0118711 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1639385339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 BURKE DR",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015461",
"telephone_number": "505-979-6102",
"fax_number": "505-863-6103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 E MESA AVE",
"city": "GALLUP",
"state": "NM",
"postal_code": "873016147",
"telephone_number": "505-979-6102",
"fax_number": "505-863-6103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOUIS",
"first_name": "ROBERT",
"middle_name": "J",
"name_suffix": "II",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0118711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "19683537",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.