Individual provider Active NPI

Stephanie Ann Rodriguez, LPCC

  • Mental Health Counselor
  • Alamogordo, NM
National Provider Identifier
1821208901
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0127871 Issued in NM
Practice address
405 Zia Ave
Alamogordo, NM 88310-4152
Phone
(575) 415-8240
Fax
(575) 443-8055
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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 0127871 NM Primary

Addresses

Primary practice location

405 Zia Ave
Alamogordo, NM 88310-4152

Mailing address

1605 George Dieter Dr Ste 636
El Paso, TX 79936-5692
Phone (915) 671-1371

Other practice location 1

1909 Cuba Ave Ste 1
Alamogordo, NM 88310-5646
Phone (575) 415-4380

Other names 1

  • Stephanie Ann Agnew Former name

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
I20240417002824 NM Practitioner - Mental Health Counselor 2961841408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1909 Cuba Ave
Suite 1
Alamogordo, NM 88310-5646
Phone (575) 415-4380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0127871NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Pathways Counseling Services LLC Mental Health CurrentSince Jan 19, 2024 Accepting new patients

Locations

1909 Cuba Ave
Ste 1
Alamogordo, NM 88310
Phone (575) 214-2800

1605 George Dieter Dr
Ste 636
El Paso, TX 79936
Phone (915) 274-1617

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1821208901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 GEORGE DIETER DR STE 636",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799365692",
            "telephone_number": "915-671-1371",
            "fax_number": "915-219-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 ZIA AVE",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883104152",
            "telephone_number": "575-415-8240",
            "fax_number": "575-443-8055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 Cuba Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Alamogordo",
            "state": "NM",
            "postal_code": "883105646",
            "country_code": "US",
            "telephone_number": "575-415-4380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0127871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "AGNEW",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alamogordo, NM

Sources for this page

Verify at the official NPI Registry.