Shyann Apodaca

Key facts

NPI

1669077939

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

License

CSA0221761 (NM)

Practice address

630 Haines Ave NW
Albuquerque, NM 87102-1226

Phone

(052) 685-6115

Fax

(505) 268-5736

NPI assigned

Dec 3, 2020

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Metro Treatment of New Mexico LP Methadone Clinic · Albuquerque, NM · NPI 1144437294
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 18, 2022.

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1669077939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 HAINES AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021226",
            "telephone_number": "052-685-6115",
            "fax_number": "505-268-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APODACA",
        "first_name": "SHYANN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0221761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

• Krystle D Apodaca, CNP
• Obelia Apodaca
• Philean T Apodaca, CPHT
• Rickey Martin Apodaca, LPCC
• Sharon Apodaca, LMSW
• Stacy Apodaca, RN
• Valerie Apodaca, MA
• Vanessa Apodaca
• Natalia Apodaka-Morales
• Apollo Chiropractic Health and Wellness, LLC

All providers in Albuquerque, NM · Addiction (Substance Use Disorder) Counselor in New Mexico