Athena Marie Gassoumis, M.DIV., LADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0087871 Issued in NM

Practice address

119 Court St
Pob 876
Socorro, NM 87801-4505

Phone

(575) 835-2389

NPI assigned

Mar 31, 2011

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 31, 2011.

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1649569575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115-119 COURT STREET",
            "address_2": "P.O.BOX 876",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "87801",
            "telephone_number": "575-835-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 COURT ST",
            "address_2": "POB 876",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878014505",
            "telephone_number": "575-835-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASSOUMIS",
        "first_name": "ATHENA",
        "middle_name": "MARIE",
        "credential": "M.DIV., LADAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0087871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delia D Garcia, RD
• Eddie Garcia
• Jocelyn Garcia
• Natalia Garcia, LMSW
• Jesse T Garza, PTA
• Angela Renee Gautier, MS LPCC
• Maurice Geurts, M.D.
• Goforth Chiropractic, LLC
• Phillip Darin Goforth, D.C.
• Timothy Paul Gonzales, CCSS

• All providers in Socorro, NM
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.