NPIMap

Organization Active NPI

Mesa Vista Wellness

  • Community/Behavioral Health Agency
  • Santa Fe, NM
National Provider Identifier
1649629114
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
0181511 Issued in NM
Legal business name
MESA VISTA WELLNESS
Practice address
2019 Galisteo St
D2
Santa Fe, NM 87505-2143
Phone
(505) 983-8225
NPI assigned
Jun 6, 2016
Last updated
Jun 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Authorized official

Name
Jonathan Wallach, LMHCNPI 1568811537
Title
Mental Health Counselor
Phone
(720) 822-6795

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 0181511 NM Primary

Addresses

Primary practice location

2019 Galisteo St
D2
Santa Fe, NM 87505-2143

Mailing address

2019 Galisteo St
D2
Santa Fe, NM 87505-2143
Phone (505) 983-8225

National Provider Directory

National Provider Directory

Locations

2019 Galisteo St
Ste D2
Santa Fe, NM 87505
Phone (505) 983-8225

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1649629114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST",
            "address_2": "D2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052143",
            "telephone_number": "505-983-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST",
            "address_2": "D2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052143",
            "telephone_number": "505-983-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA VISTA WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "WALLACH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "720-822-6795",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": "0181511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.