Active NPI
Kathie D Maestas, LMHC
- Mental Health Counselor
- Clovis, NM
National Provider Identifier
1780102285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CMH0191741
- Practice address
- 1100 W 21St St
Clovis, NM 88101 - Phone
- (575) 769-2345
- Fax
- (575) 769-9013
- NPI assigned
- Sep 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CMH0191741 | NM | Primary |
Addresses
Primary practice location
1100 W 21St St
Clovis, NM 88101
Mailing address
1100 W 21St St
Clovis, NM 88101
Phone (575) 769-2345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18055869 | Medicaid | NM |
Other names 1
- Kathie McDonald
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
| License | State | Type | Specialty |
|---|---|---|---|
| CMH0191741 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desert View, Inc. | Mental Health | Past | Accepting new patients |
| Presbyterian Medical Services | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Albuquerque, NM
- NPI 1306654462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1780102285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 W 21ST ST",
"city": "CLOVIS",
"state": "NM",
"postal_code": "88101",
"telephone_number": "575-769-2345",
"fax_number": "575-769-9013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W 21ST ST",
"city": "CLOVIS",
"state": "NM",
"postal_code": "88101",
"telephone_number": "575-769-2345",
"fax_number": "575-769-9013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAESTAS",
"first_name": "KATHIE",
"middle_name": "D",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "CMH0191741",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "18055869",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHIE",
"last_name": "MCDONALD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.