Individual provider Active NPI

Elisabeth Ana Maria Serna

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1740858448
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CTB-2023-0525 Issued in NM
Practice address
933 Bradbury Dr SE Ste 2222
Albuquerque, NM 87106-4375
Phone
(505) 272-4743
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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-2023-0525 NM Primary

Addresses

Primary practice location

933 Bradbury Dr SE Ste 2222
Albuquerque, NM 87106-4375

Mailing address

933 Bradbury Dr SE Ste 2222
Albuquerque, NM 87106-4375

Other identifiers 1

IdentifierTypeStateIssuer
UNKNOWNMedicaidNM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240528002711 NM Practitioner - Mental Health Counselor 9537501192 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CTB-2023-0525NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Hospital CurrentSince Apr 21, 2024 Accepting new patients
Unm Hospital CurrentSince Apr 21, 2024 Accepting new patients

Locations

400 Tijeras Ave NW
Ste 450
Albuquerque, NM 87102
Phone (505) 272-0148

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

2600 Marble Ave NE
Albuquerque, NM 87106
Phone (505) 272-2800

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1740858448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE STE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE STE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064375",
            "telephone_number": "505-272-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERNA",
        "first_name": "ELISABETH",
        "middle_name": "ANA MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2023-0525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UNKNOWN",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.