Active NPI
Riene Cheree Wyatt
- Mental Health Counselor
- Clovis, NM
National Provider Identifier
1952565293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0115011
- Practice address
- 121 Townsgate St
Clovis, NM 88101 - Phone
- (575) 742-2620
- NPI assigned
- Jul 16, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 0115011 | NM | Primary |
Addresses
Primary practice location
121 Townsgate St
Clovis, NM 88101
Mailing address
121 Townsgate
Clovis, NM 88101
Phone (575) 742-2620
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0115011 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216166400000",
"number": "1952565293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 TOWNSGATE",
"city": "CLOVIS",
"state": "NM",
"postal_code": "88101",
"telephone_number": "575-742-2620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 TOWNSGATE ST",
"city": "CLOVIS",
"state": "NM",
"postal_code": "88101",
"telephone_number": "575-742-2620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "RIENE",
"middle_name": "CHEREE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-16",
"last_updated": "2008-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0115011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.