Active NPI
Marcella L Skogen
- Marriage & Family Therapist
- Taos, NM
National Provider Identifier
1114466612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- CMF0199561
- Practice address
- 412 Sipapu St
Taos, NM 87571 - Phone
- (505) 690-0126
- NPI assigned
- Feb 16, 2017
- Last updated
- Oct 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | CMF0199561 | NM | Primary |
Addresses
Primary practice location
412 Sipapu St
Taos, NM 87571
Mailing address
PO Box 3209
Taos, NM 87571-3209
Phone (303) 345-8462
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70503362 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 23, 2024 through Aug 23, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CMF0199561 | NM | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538611200000",
"number": "1114466612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3209",
"city": "TAOS",
"state": "NM",
"postal_code": "875713209",
"telephone_number": "303-345-8462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 SIPAPU ST",
"city": "TAOS",
"state": "NM",
"postal_code": "87571",
"telephone_number": "505-690-0126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKOGEN",
"first_name": "MARCELLA",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-16",
"last_updated": "2018-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NM",
"license": "CMF0199561",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "70503362",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.