Individual provider Active NPI

Carolyn Tjoland, LPCC

  • Professional Counselor
  • Santa Fe, NM
National Provider Identifier
1053342659
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC 3086 Issued in NM
Practice address
901 W Alameda St
Suite 25
Santa Fe, NM 87501-1681
Phone
(505) 955-9436
Fax
(505) 955-9437
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCC 3086 NM
Professional Counselor 101YP2500X LPCC 3086 NM Primary

Addresses

Primary practice location

901 W Alameda St
Suite 25
Santa Fe, NM 87501-1681

Mailing address

PO Box 23302
Santa Fe, NM 87502-3302
Phone (505) 577-1919

Other identifiers 1

IdentifierTypeStateIssuer
57335273MedicaidNM

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
LPCC 3086NMMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1053342659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23302",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875023302",
            "telephone_number": "505-577-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W ALAMEDA ST",
            "address_2": "SUITE 25",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011681",
            "telephone_number": "505-955-9436",
            "fax_number": "505-955-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TJOLAND",
        "first_name": "CAROLYN",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "LPCC 3086",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "LPCC 3086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57335273",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.