Consuelo Christina Smith, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSA0196801 Issued in NM

Practice address

650 Vandenbosch Pkwy
Gallup, NM 87301-5508

Phone

(505) 726-6919

NPI assigned

Feb 28, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rehoboth McKinley Christian Health Care Services, Inc

  • Rural Health Clinic/Center
  • Gallup, NM
  • NPI 1689779860
  NPD (past)
• Rehoboth McKinley Christian Health Care Services, Inc

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1689784506
  NPD (past)

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1912531963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 VANDENBOSCH PKWY",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015508",
            "telephone_number": "505-726-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 VANDENBOSCH PKWY",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015508",
            "telephone_number": "505-726-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CONSUELO",
        "middle_name": "CHRISTINA",
        "name_prefix": "Ms.",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0196801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Smith, RN
• Barbara A Smith, DA
• Branden Smith
• Brooke Smith
• Cheryl Smith, RN
• Corrina Smith, RN
• Crystal Reneal Smith, RN
• Jacklyn Nelena Smith, RN
• Junko Smith
• Melanie Rachel Smith, REGISTERED NURSE

• Addiction (Substance Use Disorder) Counselor in Gallup, NM
• Providers in Gallup, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.