Laura E Renegar, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CCMH0193751 Issued in NM

Practice address

4201 Carlisle Blvd, NE,
Albuquerque, NM 87107

Phone

(505) 717-1332

Fax

(480) 396-9532

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Laura Williamson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1841305406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6811 BONITA PLAZA NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "228-860-3338",
            "fax_number": "480-396-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 CARLISLE BLVD, NE,",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87107",
            "telephone_number": "505-717-1332",
            "fax_number": "480-396-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENEGAR",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-1576",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0193751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35273704",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "WILLIAMSON",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.