MS. DENISE A MEDINA


Address: 2503 Ridge Runner Rd, Las Vegas, NM 87701
Phone: 5056170492

MS. DENISE A MEDINA (NPI# 1528106770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528106770
Entity Type Individual
Full Name MS. DENISE A MEDINA
Credential MA LMHC
Practice Address 2503 Ridge Runner Rd
Las Vegas
NM 87701
Mailing Address 410 Thunderbird Dr
Las Vegas
NM 87701-3200
Practice Telephone 5056170492
Practice Fax Number 5054252708
Mailing Telephone 5054259779
Enumeration Date 2007-02-01
Last Update Date 2018-07-11
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
2281 NM Behavioral Health & Social Service Providers

Office Location

Street Address 2503 RIDGE RUNNER RD
City LAS VEGAS
State NM
Zip Code 87701

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619474400 Camille Sarah Apodaca Community Health Worker 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2018-04-09
1285139709 Roxanne Garcia Community Health Worker 2503 Ridge Runner Rd, Las Vegas, NM 87701 2018-03-27
1699229393 Isabel Cavazos Social Worker 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2016-08-10
1679957096 Lydia Tarango Counselor 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2015-07-15
1912381336 Alyassea Vigil Counselor 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2015-07-15
1295119030 Robyn Wood Millard Counselor 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2015-07-10
1902287626 Richard Mietz Counselor 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2015-06-18
1306224910 Jacquelin Barajas Counselor 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2015-05-14
1013395714 Serafin Lopez Counselor 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2015-05-13
1952797037 Julia Fernandez Counselor 2503 Ridge Runner Rd, Las Vegas, NM 87701-4972 2015-04-15
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1750730826 John Michael Tourangeau Social Worker 1920 7th Street, Las Vegas, NM 87701 2016-06-08
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1023409521 Ambercare Medical Supply Durable Medical Equipment & Medical Supplies 1747 N Grand Ave, Las Vegas, NM 87701 2015-02-05
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City LAS VEGAS
Zip Code 87701

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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