Modern Mystic, LLC
NPI 1720445679 · Mental Health Clinic/Center (Including Community Mental Health Center) · Santa Fe, NM
Modern Mystic, LLC is a Mental Health Clinic/Center (Including Community Mental Health Center) organization in Santa Fe, NM (NPI 1720445679).
Provider details
- NPI number
- 1720445679
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Roxanne Mercurio, Licensed Mental Health Counselor(505) 231-3786
- License
- T-0174411 (NM)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense T-0174411 (NM)
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Roxanne Mercurio
Registry dates
- Enumerated
- 2016-01-23
- Last updated
- 2016-01-23
Frequently asked questions
- What is Modern Mystic, LLC's NPI number?
- Modern Mystic, LLC's National Provider Identifier (NPI) is 1720445679, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Modern Mystic, LLC?
- Modern Mystic, LLC is classified in the NPPES registry as Mental Health Clinic/Center (Including Community Mental Health Center) (Ambulatory Health Care Facilities).
- Where is Modern Mystic, LLC located?
- Modern Mystic, LLC's practice location on file with NPPES is 2213 Brothers Rd, Santa Fe, NM 87505-6993.
- What is Modern Mystic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Modern Mystic, LLC is (505) 988-7616.
- Who is the authorized official for Modern Mystic, LLC?
- The authorized official listed on Modern Mystic, LLC's NPPES record is Roxanne Mercurio, Licensed Mental Health Counselor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Modern Mystic, LLC's NPI active?
- Yes — Modern Mystic, LLC's NPI (1720445679) is active in the NPPES registry as of the last update on 2016-01-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.