Individual provider Active NPI

Matt Charles Ladish

  • Professional Counselor
  • Las Cruces, NM
National Provider Identifier
1831675602
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0387 Issued in NM
Practice address
4032 Calle de Estrellas
Las Cruces, NM 88012-7639
Phone
(575) 636-7881
NPI assigned
Jul 16, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0387 NM Primary

Addresses

Primary practice location

4032 Calle de Estrellas
Las Cruces, NM 88012-7639

Mailing address

4032 Calle de Estrellas
Las Cruces, NM 88012-7639
Phone (575) 636-7881

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
I20231127001587 NM Practitioner - Mental Health Counselor 0547618993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Counseling Las Cruces LLCGroup PAC ID 8820385271, 15 clinicians

Practice addresses (Care Compare)

530 N Church St
Las Cruces, NM 88001-3440
Phone (575) 526-9878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0387NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Las Cruces, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

530 N Church St
Las Cruces, NM 88001
Phone (575) 526-9878

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1831675602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4032 CALLE DE ESTRELLAS",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880127639",
            "telephone_number": "575-636-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4032 CALLE DE ESTRELLAS",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880127639",
            "telephone_number": "575-636-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADISH",
        "first_name": "MATT",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.