Erin Sibley Doerwald, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

08-00033470 Issued in NM

Practice address

518 Old Santa Fe TRL Ste 1
Santa Fe, NM 87505-0398

Phone

(505) 819-1492

NPI assigned

Mar 29, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Edoe LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Santa Fe, NM
  • NPI 1669978391
  NPD Authorized official

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1982109062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7430 OLD SANTA FE TRL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054574",
            "telephone_number": "505-819-1492",
            "fax_number": "505-294-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 OLD SANTA FE TRL STE 1",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875050398",
            "telephone_number": "505-819-1492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERWALD",
        "first_name": "ERIN",
        "middle_name": "SIBLEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "08-00033470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCC#",
            "identifier": "2837987",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rita Josephine Dodge, MD
• Diana Doherty, LPCC
• Yessenia Dominguez- Perea
• Linda Dominguez
• Patricia Donahue, CDE
• Rachel Haase Donahue, CRNA

• Mental Health Counselor in Santa Fe, NM
• Providers in Santa Fe, 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 Mar 29, 2018; 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.