Mary M Archibeque

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0168661 Issued in NM

Practice address

1409 Elk Ridge Rd NE
Albuquerque, NM 87113-0301

Phone

(505) 712-6451

NPI assigned

Jun 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mary M Sanchez 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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1861629883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 ELK RIDGE RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871130301",
            "telephone_number": "505-712-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 ELK RIDGE RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871130301",
            "telephone_number": "505-712-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBEQUE",
        "first_name": "MARY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0168661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12625011",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15606562",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SANCHEZ",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Archibeque, CSW
• Courtney Alicia Archibeque
• Frank A. Archibeque, M.D.
• Katlyn Archibeque
• Marie Angela Archibeque
• Theresa Archibeque
• Vanessa Archuleta- Dorrance
• Amanda L Archuleta
• April Elizabeth Archuleta, LMT
• Brenda Archuleta

• 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 Aug 4, 2015; 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.