Individual provider Active NPI

Thomas S. Bender, LPCC

  • Counselor
  • Delta, CO
National Provider Identifier
1003006131
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3377 Issued in NM
Practice address
540 Main Street
Delta, Co 81416
Delta, CO 81416-8141
Phone
(505) 681-1140
Fax
(505) 888-7943
NPI assigned
Jul 25, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3377 NM Primary

Addresses

Primary practice location

540 Main Street
Delta, Co 81416
Delta, CO 81416-8141

Mailing address

4308 Carlisle Blvd NE Ste 209
Albuquerque, NM 87107-4849
Phone (505) 681-1140

Other practice location 1

4308 Carlisle Blvd NE Ste 209
Albuquerque, NM 87107-4849
Phone (505) 681-1140 ext. 11140

Other identifiers 1

IdentifierTypeStateIssuer
3377OtherNMNEW MEXICO STATE COUNSELING LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3377NMMDOccupational Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003006131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 CARLISLE BLVD NE STE 209",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074849",
            "telephone_number": "505-681-1140",
            "fax_number": "505-888-7943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MAIN STREET",
            "address_2": "DELTA, CO 81416",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814168141",
            "telephone_number": "505-681-1140",
            "fax_number": "505-888-7943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4308 Carlisle Blvd NE Ste 209",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871074849",
            "country_code": "US",
            "telephone_number": "505-681-1140 x11140",
            "fax_number": "505-888-7943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENDER",
        "first_name": "THOMAS",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NM",
            "license": "3377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO STATE COUNSELING LICENSE",
            "identifier": "3377",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.