NPIMap

Organization Active NPI

Clear Lake Studio, LLC

  • Counselor
  • Las Cruces, NM
National Provider Identifier
1003204702
Registry record updated Jan 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
0150641 Issued in NM
Legal business name
CLEAR LAKE STUDIO, LLC
Practice address
1925 Anita Dr
Las Cruces, NM 88001-2027
Phone
(915) 345-5489
Fax
(575) 541-3690
NPI assigned
Jan 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2015

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

Authorized official

Name
Ms. Ann M Skirvin
Title
Office Manager
Phone
(915) 345-5489

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 0150641 NM Primary

Addresses

Primary practice location

1925 Anita Dr
Las Cruces, NM 88001-2027

Mailing address

1925 Anita Dr
Las Cruces, NM 88001-2027
Phone (915) 345-5489

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1420243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420243200000",
    "number": "1003204702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 ANITA DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880012027",
            "telephone_number": "915-345-5489",
            "fax_number": "575-541-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 ANITA DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880012027",
            "telephone_number": "915-345-5489",
            "fax_number": "575-541-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LAKE STUDIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-03",
        "last_updated": "2015-01-03",
        "status": "A",
        "authorized_official_last_name": "SKIRVIN",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "915-345-5489",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "NM",
            "license": "0150641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2015; 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.