Active NPI
Gwendolyn Minton, LSAI
- Addiction (Substance Use Disorder) Counselor
- Las Vegas, NM
National Provider Identifier
1710016936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 4460
- Practice address
- 700 Friedman Ave
Las Vegas, NM 87701-4231 - Phone
- (505) 454-5100
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 4460 | NM | Primary |
Addresses
Primary practice location
700 Friedman Ave
Las Vegas, NM 87701-4231
Mailing address
700 Friedman Ave
Las Vegas, NM 87701-4231
Phone (505) 454-5100
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4460 | NM | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710016936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 FRIEDMAN AVE",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014231",
"telephone_number": "505-454-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 FRIEDMAN AVE",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014231",
"telephone_number": "505-454-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTON",
"first_name": "GWENDOLYN",
"credential": "LSAI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NM",
"license": "4460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.