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DR. JEDEDIAH WALLS LMHC, ATR-P
NPI 1174272397
Counselor - Mental Health in Las Cruces, NM

Active since March 23, 2022PECOS Enrolled
133 WYATT DR STE 3, LAS CRUCES, NM 88005(575) 526-9878 Get Directions Write a Review

NPPES record last updated: March 23, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jedediah Walls Lmhc, Atr-p NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEDEDIAH WALLS LMHC, ATR-P (NPI 1174272397) is an individual mental health provider in Las Cruces, New Mexico, licensed in New Mexico (CTB-2022-0028) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1174272397
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDR. JEDEDIAH WALLSCredential: LMHC, ATR-P
Location Address133 WYATT DR STE 3Las Cruces, NM 88005-2962
Mailing Address1304 Greenwood LnAlamogordo, NM 88310-5742 · (574) 310-3789
Phone(575) 526-9878
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 23, 2022
NPPES CertifiedMarch 23, 2022
✔ NPI 1174272397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NM · CTB-2022-0028
133 WYATT DR STE 3, Las Cruces, NM 88005
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jedediah Walls Lmhc, Atr-p is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183145022
PECOS Enrollment IDI20250307000241
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jedediah Walls's NPI number?

The NPI number for Jedediah Walls is 1174272397. It was assigned to this individual provider in the NPPES registry on March 23, 2022.

Where is Jedediah Walls located?

Jedediah Walls practices at 133 Wyatt Dr Ste 3, Las Cruces, NM 88005. The listed phone number is (575) 526-9878.

What is Jedediah Walls's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jedediah Walls enrolled in Medicare?

Yes. Jedediah Walls is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jedediah Walls was last updated on March 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.