Active NPI
Phyllis A Blair, PHD, LPCC
- Mental Health Counselor
- Abiquiu, NM
National Provider Identifier
1891866943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- NM LPCC 2380
- Practice address
- Hwy 554 Gate 110
Abiquiu, NM 87510-0631 - Phone
- (505) 685-4052
- NPI assigned
- Nov 12, 2006
- Last updated
- Jul 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NM LPCC 2380 | NM | Primary |
Addresses
Primary practice location
Hwy 554 Gate 110
Abiquiu, NM 87510-0631
Mailing address
132 Romero St
#7
Santa Fe, NM 87501-7302
Phone (505) 820-7515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00N776 | Other | NM | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NM LPCC 2380 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1891866943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 ROMERO ST",
"address_2": "#7",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875017302",
"telephone_number": "505-820-7515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HWY 554 GATE 110",
"city": "ABIQUIU",
"state": "NM",
"postal_code": "875100631",
"telephone_number": "505-685-4052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR",
"first_name": "PHYLLIS",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-12",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "NM LPCC 2380",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00N776",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Abiquiu, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.