Active NPI
Jesse Lee Baca, LPCC
- Professional Counselor
- Rio Rancho, NM
National Provider Identifier
1972151728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CTB-2024-0200
- Practice address
- 4210 Meadowlark LN SE
Rio Rancho, NM 87124-1021 - Phone
- (505) 425-6788
- NPI assigned
- Aug 26, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CTB-2024-0200 | NM | Primary |
Addresses
Primary practice location
4210 Meadowlark LN SE
Rio Rancho, NM 87124-1021
Mailing address
PO Box 158
Espanola, NM 87532-0158
Phone (505) 753-7218
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 |
|---|---|---|---|
| CTB-2024-0200 | NM | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746403200000",
"number": "1972151728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 158",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875320158",
"telephone_number": "505-753-7218",
"fax_number": "505-426-3492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 MEADOWLARK LN SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241021",
"telephone_number": "505-425-6788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACA",
"first_name": "JESSE",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-26",
"last_updated": "2025-05-05",
"certification_date": "2025-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "CTB-2024-0200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.