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EMILY FOSSUM LPCC
NPI 1528501079
Counselor - Professional in Espanola, NM

Active since November 30, 2016PECOS Enrolled
835 SPRUCE ST STE C&D, ESPANOLA, NM 87532(505) 747-7400(505) 747-7403 Get Directions Write a Review

NPPES record last updated: April 25, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 25, 2024, Oct 25, 2023 (2 updates tracked since 2023).

About Emily Fossum Lpcc NPPES

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

EMILY FOSSUM LPCC (NPI 1528501079) is an individual professional provider in Espanola, New Mexico, licensed in New Mexico (CCMH0224041) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1528501079
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameEMILY FOSSUMCredential: LPCC
Location Address835 SPRUCE ST STE C&DEspanola, NM 87532-3455
Mailing Address835 Spruce St Ste C&dEspanola, NM 87532-3455 · (505) 747-7400 · Fax (505) 747-7403
Phone(505) 747-7400
Fax(505) 747-7403
Sole ProprietorNo
Enumeration DateNovember 30, 2016
Last NPPES UpdateApril 25, 20242 updates tracked since enumeration
NPPES CertifiedApril 25, 2024
✔ NPI 1528501079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in NM · CCMH0224041✔ Licensed in MN · CC01318
835 SPRUCE ST STE C&D, Espanola, NM 87532
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Other Names 1

Former Name (1)Emily Maria Raffel L.p.c.c.

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Emily Fossum Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Emily Fossum reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Presbyterian Medical Services
Same address
Federally Qualified Health Center (FQHC)
835 SPRUCE ST, C & D
Espanola, NM 87532
  • Reassigned Medicare billing, New Mexico enrollment
  • 322 clinicians in this Medicare group
NPI 1306175922 (505) 747-7400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FLOYD ZAMORA CSW PSR
Case Manager/Care Coordinator
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532
Rio Arriba County (505) 747-7400
ADRIANNA B SUAZO LMHC
Counselor (Mental Health)
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532
Rio Arriba County (505) 747-7400
MERCY BURTON RUSSELL LCSW
Social Worker (Clinical)
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532
Rio Arriba County (505) 747-7400
DAWAN JUDE BENDER CSW
Case Manager/Care Coordinator
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532
Rio Arriba County (505) 747-7400
AMANDA ABEYTA LADAC
Counselor (Addiction (Substance Use Disorder))
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532
Rio Arriba County (505) 747-7400
MARGARET M. TRIVINO PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532
Rio Arriba County (505) 747-0081
SHEILA SCREDON MONTOYA LMHC
Counselor (Mental Health)
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532
Rio Arriba County (505) 747-7400
MR. ANGELO SANDOVAL LCSW
Social Worker (Clinical)
835 SPRUCE ST STE C&D
ESPANOLA, NM 87532
Rio Arriba County (505) 747-7400

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 Emily Fossum's NPI number?

The NPI number for Emily Fossum is 1528501079. It was assigned to this individual provider in the NPPES registry on November 30, 2016. The provider is also known as Emily Maria Raffel L.P.C.C..

Where is Emily Fossum located?

Emily Fossum practices at 835 Spruce St Ste C&d, Espanola, NM 87532. The listed phone number is (505) 747-7400.

What is Emily Fossum's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Emily Fossum enrolled in Medicare?

Yes. Emily Fossum is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Emily Fossum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emily Fossum reassigns Medicare benefits to Presbyterian Medical Services (Espanola, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Emily Fossum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Emily Fossum was last updated on April 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.