Individual provider Active NPI

David Ebeling, LMHC

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1710261797
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CMH0152191 Issued in NM
Practice address
2617 Juan Tabo Blvd NE Ste Ad
Albuquerque, NM 87112-2966
Phone
(505) 295-3159
Fax
(505) 266-2502
NPI assigned
Oct 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CMH0152191 NM Primary

Addresses

Primary practice location

2617 Juan Tabo Blvd NE Ste Ad
Albuquerque, NM 87112-2966

Mailing address

508 Tennessee St NE Apt D
Albuquerque, NM 87108-2356
Phone (505) 331-9549

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

LicenseStateTypeSpecialty
CMH0152191NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1710261797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 TENNESSEE ST NE APT D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082356",
            "telephone_number": "505-331-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 JUAN TABO BLVD NE STE AD",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122966",
            "telephone_number": "505-295-3159",
            "fax_number": "505-266-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBELING",
        "first_name": "DAVID",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-07",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CMH0152191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Nov 26, 2018; 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.