Active NPI
Carol R Burks, PH.D.
- Counseling Psychologist
- Las Cruces, NM
National Provider Identifier
1174671879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 651
- Practice address
- 301 Perkins Dr
Ste. C
Las Cruces, NM 88005-3248 - Phone
- (505) 524-8404
- Fax
- (505) 524-8406
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 651 | NM | Primary |
Addresses
Primary practice location
301 Perkins Dr
Ste. C
Las Cruces, NM 88005-3248
Mailing address
301 Perkins Dr
Ste. C
Las Cruces, NM 88005-3248
Phone (505) 524-8404
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VNM0038 | Other | NM | VALUE OPTIONS |
| NM100989 | Medicaid | NM | |
| NM01NL36 | Other | NM | BCBS OF NM |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 651 | NM | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caroline B Williams PHD PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Prescribing (Medical) Psychologist
- Boerne, TX
- NPI 1356316814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193011200000",
"number": "1174671879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 PERKINS DR",
"address_2": "STE. C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053248",
"telephone_number": "505-524-8404",
"fax_number": "505-524-8406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 PERKINS DR",
"address_2": "STE. C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053248",
"telephone_number": "505-524-8404",
"fax_number": "505-524-8406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKS",
"first_name": "CAROL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2007-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NM",
"license": "651",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "VNM0038",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NM100989",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NM",
"identifier": "NM01NL36",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.