Individual provider Active NPI

Mary L Freddie, LMHC

  • Mental Health Counselor
  • Farmington, NM
National Provider Identifier
1801106018
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0135491 Issued in NM
Practice address
2700 Farmington Ave BLDG F
Farmington, NM 87401-4559
Phone
(505) 326-7878
Fax
(505) 326-7879
NPI assigned
Oct 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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 0135491 NM Primary

Addresses

Primary practice location

2700 Farmington Ave BLDG F
Farmington, NM 87401-4559

Mailing address

2700 Farmington Ave BLDG F
Farmington, NM 87401-4559
Phone (505) 326-7878

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
0135491NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1801106018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 FARMINGTON AVE BLDG F",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874014559",
            "telephone_number": "505-326-7878",
            "fax_number": "505-326-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 FARMINGTON AVE BLDG F",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874014559",
            "telephone_number": "505-326-7878",
            "fax_number": "505-326-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDDIE",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0135491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.