Individual provider Active NPI

Miriam V Rivas, LPCC, LPC

  • Professional Counselor
  • Santa Teresa, NM
National Provider Identifier
1811015647
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0128131 Issued in NM
Practice address
5305 McNutt Rd Ste E
Santa Teresa, NM 88008-9685
Phone
(915) 203-5103
Fax
(915) 351-6601
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0110021 NM
Professional Counselor 101YP2500X 66211 TX
Professional Counselor 101YP2500X 0128131 NM Primary

Addresses

Primary practice location

5305 McNutt Rd Ste E
Santa Teresa, NM 88008-9685

Mailing address

5290 McNutt Rd Ste. 211 #1137
Santa Teresa, NM 88008-9694
Phone (915) 203-5103

Other identifiers 1

IdentifierTypeStateIssuer
NM600035OtherNMNM MEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731003110 NM Practitioner - Mental Health Counselor 9335686914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5305 McNutt Rd
Suite E
Santa Teresa, NM 88008-9685
Phone (915) 203-5103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110021NMMDMental Health Counselor
0128131NMMDProfessional Counselor
66211TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bienestar Family Counseling Center, LLC Professional CurrentSince May 22, 2024 Accepting new patients

Locations

5305 McNutt Rd
Ste E
Santa Teresa, NM 88008
Phone (915) 203-5103

5290 McNutt Rd
Unit 1137
Santa Teresa, NM 88008

4950 McNutt Rd
Sunland Park, NM 88008
Phone (575) 882-6101

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1811015647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5290 MCNUTT RD STE. 211 #1137",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089694",
            "telephone_number": "915-203-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 MCNUTT RD STE E",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089685",
            "telephone_number": "915-203-5103",
            "fax_number": "915-351-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "MIRIAM",
        "middle_name": "V",
        "name_prefix": "Ms.",
        "credential": "LPCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0110021",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "66211",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0128131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM MEDICAID",
            "identifier": "NM600035",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Teresa, NM

Sources for this page

Verify at the official NPI Registry.