Jill M Tiedemann, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

T3476 Issued in NM

Practice address

1601A Saint Michaels Dr
Santa Fe, NM 87505-7614

Phone

(505) 954-8777

Fax

(505) 954-8793

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Su Vida

  • Clinical Social Worker
  • Santa Fe, NM
  • NPI 1629009899
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104851534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601A SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057614",
            "telephone_number": "505-954-8777",
            "fax_number": "505-954-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601A SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057614",
            "telephone_number": "505-954-8777",
            "fax_number": "505-954-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDEMANN",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T3476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "NM600536",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willa B Thorpe
• Elsie Katherine Thrift, LPCC
• Thrive Neuropsychology & Psychology
• Karin Elizabeth Thron, M.D.
• Jean Eva Thumm-Bochenski, LMFT
• Tierra Alta Neuropsychology LLC
• Tierra Nueva Counseling Center, LLC
• Lauren K Tietz, LMT, CST, TRE
• Maria Anna Tiffany, LMFT
• Felicia Mae Tillman, M.D.

• 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 Jul 8, 2007; 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.