Active NPI
Jeremy E Estrada, CCHW
- Counselor
- Las Vegas, NM
National Provider Identifier
1801120365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1235 8TH St
Las Vegas, NM 87701-4219 - Phone
- (505) 425-6788
- NPI assigned
- Sep 30, 2009
- Last updated
- Jul 27, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1235 8TH St
Las Vegas, NM 87701-4219
Mailing address
PO Box 28220
Santa Fe, NM 87592-8220
Phone (505) 471-5006
Other practice location 1
720 University Ave
Las Vegas, NM 87701-4250
Phone (505) 454-8265
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1801120365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 28220",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875928220",
"telephone_number": "505-471-5006",
"fax_number": "505-820-9220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 8TH ST",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014219",
"telephone_number": "505-425-6788"
}
],
"practiceLocations": [
{
"address_1": "720 University Ave",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NM",
"postal_code": "877014250",
"country_code": "US",
"telephone_number": "505-454-8265",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ESTRADA",
"first_name": "JEREMY",
"middle_name": "E",
"credential": "CCHW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-30",
"last_updated": "2023-07-27",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.