Individual provider Active NPI

Jose Eduardo Gallegos, LMHC

  • Mental Health Counselor
  • Anthony, NM
National Provider Identifier
1720806003
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CTB-2024-0676 Issued in NM
Practice address
PO Box 2671
Anthony, NM 88021-2671
Phone
(575) 882-5100
Fax
(575) 882-1151
NPI assigned
Sep 26, 2024
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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 CTB-2024-0676 NM Primary

Addresses

Primary practice location

PO Box 2671
Anthony, NM 88021-2671

Mailing address

PO Box 2671
Anthony, NM 88021-2671
Phone (575) 882-5100

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

LicenseStateTypeSpecialty
CTB-2024-0676NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1720806003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2671",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "880212671",
            "telephone_number": "575-882-5100",
            "fax_number": "575-882-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 2671",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "880212671",
            "telephone_number": "575-882-5100",
            "fax_number": "575-882-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "JOSE",
        "middle_name": "EDUARDO",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2024-0676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anthony, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.