Active NPI
Laurie Mae Grant Desilvera
- Mental Health Counselor
- Santa Fe, NM
National Provider Identifier
1972790194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- T -0107501
- Practice address
- 5312 Jaguar Dr
Santa Fe, NM 87507-1827 - Phone
- (505) 471-5006
- NPI assigned
- Oct 2, 2007
- 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 | T -0107501 | NM | Primary |
Addresses
Primary practice location
5312 Jaguar Dr
Santa Fe, NM 87507-1827
Mailing address
5312 Jaguar Dr
Santa Fe, NM 87507-1827
Phone (505) 471-5006
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 |
|---|---|---|---|
| T -0107501 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191283200000",
"number": "1972790194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5312 JAGUAR DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875071827",
"telephone_number": "505-471-5006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5312 JAGUAR DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875071827",
"telephone_number": "505-471-5006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESILVERA",
"first_name": "LAURIE",
"middle_name": "MAE GRANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-02",
"last_updated": "2007-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "T -0107501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.