Active NPI
Charles Edward Neelley Jr., LMHC
- Professional Counselor
- Taos, NM
National Provider Identifier
1679240998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CMH0151031
- Practice address
- 105 Bertha Rd Ste B
Taos, NM 87571-7148 - Phone
- (575) 758-4297
- NPI assigned
- Aug 24, 2021
- Last updated
- Aug 24, 2021
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CMH0151031 | NM | Primary |
Addresses
Primary practice location
105 Bertha Rd Ste B
Taos, NM 87571-7148
Mailing address
PO Box 1598
Taos, NM 87571-1598
Phone (575) 779-2294
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
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
105 Bertha Rd
Suite B
Taos, NM 87571-7148
Phone (575) 770-8136
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CMH0151031 | NM | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nonviolence Works, Inc. | Current | Accepting new patients |
Locations
105 Bertha Rd
Ste B
Taos, NM 87571
Phone (575) 758-4297
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Taos, NM
- NPI 1376777607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629763200000",
"number": "1679240998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1598",
"city": "TAOS",
"state": "NM",
"postal_code": "875711598",
"telephone_number": "575-779-2294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 BERTHA RD STE B",
"city": "TAOS",
"state": "NM",
"postal_code": "875717148",
"telephone_number": "575-758-4297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEELLEY",
"first_name": "CHARLES",
"middle_name": "EDWARD",
"name_suffix": "Jr.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-24",
"last_updated": "2021-08-24",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "CMH0151031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.