Healthcare Provider Details
I. General information
NPI: 1881322154
Provider Name (Legal Business Name): MASN, LLC / NEW LIGHT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2022
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1424 DEBORAH RD SE STE 205
RIO RANCHO NM
87124-6619
US
IV. Provider business mailing address
3169 ASHKIRK LOOP SE
RIO RANCHO NM
87124-3614
US
V. Phone/Fax
- Phone: 505-225-3194
- Fax: 505-212-6336
- Phone: 281-202-7207
- Fax: 505-212-6336
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEGAN
J
LINDSTROM
Title or Position: OWNER
Credential: LCSW
Phone: 505-225-3194