Organization Active NPI

Pupfish LLC

  • Professional Counselor
  • El Paso, TX
National Provider Identifier
1023587334
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
PUPFISH LLC
Practice address
279 Shadow Mountain Dr # 307
El Paso, TX 79912-4707
Phone
(713) 504-2681
NPI assigned
Nov 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Authorized official

Name
Joseph Carlson, LPCNPI 1508382599
Title
Owner/LPC
Phone
(713) 504-2681

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

279 Shadow Mountain Dr # 307
El Paso, TX 79912-4707

Mailing address

6848 Orizaba Ave
El Paso, TX 79912-2306
Phone (713) 504-2681

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241021003760 TX Part B Supplier - Clinic/Group Practice 2567994155 Receives reassigned benefits from 2 practitioners
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

7001 Westwind Dr
Ste 108
El Paso, TX 79912
Phone (713) 504-2681

279 Shadow Mountain Dr
#307
El Paso, TX 79912
Phone (713) 504-2681

Practitioners & affiliated clinicians

Practitioners 3

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": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1023587334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6848 ORIZABA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799122306",
            "telephone_number": "713-504-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SHADOW MOUNTAIN DR # 307",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799124707",
            "telephone_number": "713-504-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUPFISH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/LPC",
        "authorized_official_telephone_number": "713-504-2681",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.