NPIMap

Organization Active NPI

Wise Mind Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Albuquerque, NM
National Provider Identifier
1689228579
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WISE MIND COUNSELING
Practice address
2424 Juan Tabo Blvd NE
Albuquerque, NM 87112-1818
Phone
(505) 317-3792
Fax
(505) 792-6611
NPI assigned
Jul 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Authorized official

Name
Samantha RueNPI 1598089344
Title
Co-Owner
Phone
(505) 317-3792

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2424 Juan Tabo Blvd NE
Albuquerque, NM 87112-1818

Mailing address

PO Box 1568
Rio Rancho, NM 87174

Other identifiers 1

IdentifierTypeStateIssuer
92756069MedicaidNM

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL wisemindnm@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200319000377 NM Part B Supplier - Clinic/Group Practice 5193153526 Receives reassigned benefits from 13 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

8214 2nd St NW
Ste C
Albuquerque, NM 87114
Phone (505) 317-3792

2424 Juan Tabo Blvd NE
Albuquerque, NM 87112
Phone (505) 317-3792

2420 Juan Tabo Blvd NE
Albuquerque, NM 87112
Phone (505) 292-2237

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1689228579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1568",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "87174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121818",
            "telephone_number": "505-317-3792",
            "fax_number": "505-792-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MIND COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-29",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "RUE",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "505-317-3792"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92756069",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "wisemindnm@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1590 Valley Vista Ct SE",
            "city": "Rio Rancho",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871242862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.