NPIMap

Organization Active NPI

Equanimity Counseling and Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gardnerville, NV
National Provider Identifier
1124878285
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EQUANIMITY COUNSELING AND PSYCHOLOGICAL SERVICES
Practice address
1462 US Highway 395 N
Gardnerville, NV 89410-5203
Phone
(775) 553-0668
Fax
(775) 319-5922
NPI assigned
Mar 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Authorized official

Name
Mary Angela Pulido-Banner, PHDNPI 1790910669
Title
Owner/Psychologist
Phone
(775) 553-0668

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

1462 US Highway 395 N
Gardnerville, NV 89410-5203

Mailing address

6700 N Linder Rd, Ste 156a
#331
Meridian, ID 83646
Phone (775) 553-0668

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1711065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1124878285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 N LINDER RD, STE 156A",
            "address_2": "#331",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83646",
            "telephone_number": "775-553-0668",
            "fax_number": "775-319-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 US HIGHWAY 395 N",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105203",
            "telephone_number": "775-553-0668",
            "fax_number": "775-319-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUANIMITY COUNSELING AND PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "PULIDO-BANNER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "775-553-0668",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardnerville, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.