Individual provider Active NPI

Annalisa Golowacz, MA, LPCC

  • Mental Health Counselor
  • Los Lunas, NM
National Provider Identifier
1770853228
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0122501 Issued in NM
Practice address
428 Los Lentes, SE
Los Lunas, NM 87031
Phone
(505) 807-1534
NPI assigned
Dec 30, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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 0122501 NM Primary

Addresses

Primary practice location

428 Los Lentes, SE
Los Lunas, NM 87031

Mailing address

PO Box 3301
Los Lunas, NM 87031-3301
Phone (505) 807-1534

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0122501NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1770853228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3301",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870313301",
            "telephone_number": "505-807-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 LOS LENTES, SE",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "87031",
            "telephone_number": "505-807-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOWACZ",
        "first_name": "ANNALISA",
        "name_prefix": "Ms.",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0122501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.