MARY SUE BLACKHURST (NPI# 1417938952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417938952 |
| Entity Type | Individual |
| Full Name | MARY SUE BLACKHURST |
| Credential | LPCC |
| Practice Address |
110 E Mescalero Rd Roswell NM 88201-6542 |
| Mailing Address |
110 E Mescalero Rd Roswell NM 88201 |
| Practice Telephone | 5757552272 |
| Practice Fax Number | 5756223325 |
| Mailing Telephone | (575) 755-2272 |
| Mailing Fax Number | 5756223325 |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
0080161 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 9057051 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 914 N Canal St, Carlsbad, NM 882205110 | 5058854836 | 5058879579 |
| Street Address |
110 E MESCALERO RD |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201-6542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154939502 | Madison Holm | Case Manager/Care Coordinator | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2020-07-21 |
| 1346884517 | Marisa Juarez | Case Manager/Care Coordinator | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-10-31 |
| 1346897634 | Erin Jeanette Montgomery | Marriage & Family Therapist | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-08-21 |
| 1255985693 | Misty Renee Sturtevant | Social Worker | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-07-24 |
| 1205488715 | Sara Michelle Rodriguez | Counselor | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-07-15 |
| 1801355672 | Camille Berrones | Social Worker | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-03-19 |
| 1346721933 | Rebeca Vazquez | Case Manager/Care Coordinator | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2018-08-22 |
| 1104315985 | Johnny Ray Ibarra | Social Worker | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2018-05-07 |
| 1528565959 | Jazmin E Sarabia | Case Manager/Care Coordinator | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2018-04-11 |
| 1912415290 | Markay Hickerson | Social Worker | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2018-01-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
| Find all providers in zip 88201 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235777483 | Meredith L Price | Counselor | 555 Sun Valley Dr Ste M2, Roswell, GA 30076-5631 | 2019-12-18 |
| 1760990543 | David Sherwood | Counselor | 11705 King Rd, Roswell, GA 30075-7701 | 2018-01-16 |
| 1669990743 | Amber Fort | Counselor | 10929 Crabapple Rd Ste C, Roswell, GA 30075-7657 | 2017-09-08 |
| 1740722370 | Sharon Nix | Counselor | 11940 Chaffin Rd, Roswell, GA 30075-1479 | 2016-11-14 |
| 1447635859 | Stephanie Lemmey | Counselor | 1905 Woodstock Rd Ste 6200, Roswell, GA 30075-5630 | 2015-07-27 |
| 1790172849 | Mashallah Shakur | Counselor | 3438 Laurelwood Ct Ne, Roswell, GA 30075-5250 | 2015-04-15 |
| 1659615961 | Heig Ashot Merijanian | Counselor | 12080 Mountain Laurel Dr, Roswell, GA 30075-1220 | 2012-11-27 |
| 1427316520 | Camie L. Vincent | Counselor | 10929 Crabapple Rd Ste 201e, Roswell, GA 30075-5856 | 2012-04-26 |
| 1801161112 | Adele Teresa Hernandez | Counselor | 580 Hembree Rd., Roswell, GA 30076 | 2012-03-20 |
| 1134411812 | Shannon Brookshire Barnes | Counselor | 11577 Point Place, Roswell, GA 30076 | 2011-05-12 |
| Find all providers in ROSWELL | ||||
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| 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.