Raven Counseling and Wellness LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0100131 Issued in NM

Legal business name

RAVEN COUNSELING AND WELLNESS LLC

Practice address

8625 Golf Course Rd NW Ste B2
Albuquerque, NM 87114-5114

Phone

(505) 508-0808

Fax

(888) 896-8728

NPI assigned

Nov 3, 2009

Organization subpart

No

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

Authorized official

Name

Tanya Medina, CPB-COC

Title

Billing & Network

Phone

(505) 508-0808

Specialties & licenses 4

Addresses

Other identifiers 5

Other names 1

• Raven Counseling and Wellness LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sheena Bachelor-Evridge, LMHC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1780740100

  Mental Health

  Medicare reassignment Care Compare group NPD
• Julita Gloria Pezzano, LPCC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1720292782

  Mental Health

  Medicare reassignment Care Compare group NPD
• Jacob P Torrez, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1942516547
  Medicare reassignment NPD
• Kristine Aguirre, LCSW

  • Counselor
  • Albuquerque, NM
  • NPI 1285005314
  NPD
• Kristapher Harris, LPCC

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1114234655
  NPD
• Naomi Moppert

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1700322146
  NPD
• Lenore Geralyn Baeli Wang, M.A., M.F.A., LMHC

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1831394022
  NPD (past)
• Elizabeth Jo Chavez, LPC

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1346338027
  NPD (past)
• Jodie L Hart, LMSW

  • Clinical Social Worker
  • Los Ranchos, NM
  • NPI 1093049785
  NPD (past)
• Jessica Werling

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1124320361
  NPD (past)

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

{
    "created_epoch": "1257206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765238400000",
    "number": "1780911347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8625 GOLF COURSE RD NW STE B2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145114",
            "telephone_number": "505-508-0808",
            "fax_number": "888-896-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8625 GOLF COURSE RD NW STE B2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145114",
            "telephone_number": "505-508-0808",
            "fax_number": "888-896-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVEN COUNSELING AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-03",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "BILLING & NETWORK",
        "authorized_official_telephone_number": "505-508-0808",
        "authorized_official_credential": "CPB-COC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0100131",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNETWORKGROUPPRACTICE",
            "identifier": "00NM00TQ09",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUMBEHAVIORALHEALTH",
            "identifier": "003165431",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58973303",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHCADVANTAGEPLANS",
            "identifier": "GL000004020499",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLANHEALTHCARE",
            "identifier": "600670197",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Raven Counseling and Wellness LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal J Ratliffe
• Addison Ann Rauch, CNP
• Julia Summer Rauchfuss, MD
• Julie Raulerson, MS CCC-SLP
• Melissa Ravago, D.M.D.
• Denise M Raven, LISW
• Raja Ravender, MD
• Ravensnow L.L.C.
• Katherine Choe Raver, FNP-C
• Sahil Rawal, DO

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.