Active NPI
Nathan Interial, LPCC
- Professional Counselor
- Rio Rancho, NM
National Provider Identifier
1811386337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CCMH0206861
- Practice address
- 712 Saratoga Dr NE
Rio Rancho, NM 87124-4624 - Phone
- (505) 595-7093
- NPI assigned
- Jan 21, 2015
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CCMH0206861 | NM | Primary |
Addresses
Primary practice location
712 Saratoga Dr NE
Rio Rancho, NM 87124-4624
Mailing address
1380 Rio Rancho Blvd
#107
Rio Rancho, NM 87124
Phone (505) 595-7093
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 |
|---|---|---|---|
| CCMH0206861 | NM | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Journey of Hope and Courage LLC | Mental Health | Current | Accepting new patients |
Locations
1380 Rio Rancho Blvd SE
Rio Rancho, NM 87124
Phone (505) 916-4729
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.
-
- Mental Health Counselor
- Rio Rancho, NM
- NPI 1710635388
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1811386337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1380 RIO RANCHO BLVD",
"address_2": "#107",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "87124",
"telephone_number": "505-595-7093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 SARATOGA DR NE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871244624",
"telephone_number": "505-595-7093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INTERIAL",
"first_name": "NATHAN",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-21",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "CCMH0206861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.