Santa Fe Dialectical Behavior Therapy, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SANTA FE DIALECTICAL BEHAVIOR THERAPY, LLC

Practice address

411 Saint Michaels Dr
Suite 2
Santa Fe, NM 87505-7655

Phone

(505) 983-8502

NPI assigned

Jan 8, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Jill M Tiedemann, LPCC

Title

Team Leader

Phone

(505) 983-8502

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Randi Ya'El Chaikind, LPCC

  • Professional Counselor
  • Santa Fe, NM
  • NPI 1750889903
  NPD (past)

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1023355252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 SAINT MICHAELS DR",
            "address_2": "SUITE 2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057655",
            "telephone_number": "505-983-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 SAINT MICHAELS DR",
            "address_2": "SUITE 2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057655",
            "telephone_number": "505-983-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA FE DIALECTICAL BEHAVIOR THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "TIEDEMANN",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "TEAM LEADER",
        "authorized_official_telephone_number": "505-983-8502",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.