Active NPI
Douglas John Lindsey, LMSW, LPCC
- Professional Counselor
- Gallup, NM
National Provider Identifier
1699701821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 516 E. Nizhoni Blvd.
Gallup, NM 87301-1337 - Phone
- (505) 722-1000
- Fax
- (505) 722-1396
- NPI assigned
- Jun 22, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2835 | NM | |
| Social Worker | 104100000X | M-1108 | NM | |
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
516 E. Nizhoni Blvd.
Gallup, NM 87301-1337
Mailing address
PO Box 1349
Silver City, NM 87305-1337
Phone (505) 388-4497
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15927334 | Medicaid | NM | |
| 42276870 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2835 | NM | MD | Mental Health Counselor |
| M-1108 | NM | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Border Area Mental Health Services, Inc | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Silver City, NM
- NPI 1609886787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263340800000",
"number": "1699701821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1349",
"city": "SILVER CITY",
"state": "NM",
"postal_code": "873051337",
"telephone_number": "505-388-4497",
"fax_number": "575-534-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 E. NIZHONI BLVD.",
"city": "GALLUP",
"state": "NM",
"postal_code": "873011337",
"telephone_number": "505-722-1000",
"fax_number": "505-722-1396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINDSEY",
"first_name": "DOUGLAS",
"middle_name": "JOHN",
"credential": "LMSW, LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2010-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "2835",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M-1108",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15927334",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42276870",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.