Lorenzo R Jim, LADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0125371 Issued in NM

Practice address

5608 Zuni Rd SE
Albuquerque, NM 87108-2926

Phone

(505) 262-2481

Fax

(505) 265-7045

NPI assigned

Sep 10, 2009

Last updated

Sep 10, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1710210513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5608 ZUNI RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082926",
            "telephone_number": "505-262-2481",
            "fax_number": "505-265-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5608 ZUNI RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082926",
            "telephone_number": "505-262-2481",
            "fax_number": "505-265-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIM",
        "first_name": "LORENZO",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LADAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-10",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0125371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0125371",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.