Mountain Pass Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0174601 Issued in NM

Legal business name

MOUNTAIN PASS COUNSELING, LLC

Practice address

11930 Menaul Blvd NE
Ste 114-a
Albuquerque, NM 87112-2478

Phone

(262) 617-6446

NPI assigned

Nov 29, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Diane Marie Bast, MS

Title

Clinical Mental Health Counselor

Phone

(262) 617-6446

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1448755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448755200000",
    "number": "1972977015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 KINGFISHER LN",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870597432",
            "telephone_number": "262-617-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 MENAUL BLVD NE",
            "address_2": "STE 114-A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122478",
            "telephone_number": "262-617-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN PASS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-29",
        "last_updated": "2015-11-29",
        "status": "A",
        "authorized_official_last_name": "BAST",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CLINICAL MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "262-617-6446",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0174601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43711500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2015; 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.