Individual provider Active NPI

Christine Lynn Tierramar, LPC

  • Mental Health Counselor
  • Boulder, CO
National Provider Identifier
1184212813
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC.0016510 Issued in CO
Practice address
4710 Table Mesa Dr
Boulder, CO 80305-4503
Phone
(313) 614-3177
NPI assigned
Jan 7, 2021
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC.0016510 CO Primary

Addresses

Primary practice location

4710 Table Mesa Dr
Boulder, CO 80305-4503

Mailing address

4636 Talbot Dr
Boulder, CO 80303-2620
Phone (313) 614-3177

Other practice location 1

4636 Talbot Dr
Boulder, CO 80303-2620
Phone (313) 614-3177

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

Practice roles

OrganizationSpecialtyStatusNew patients
Humanistic Counseling, LLC Counselor CurrentSince Oct 1, 2021 Accepting new patients

Locations

1800 30th St
Ste 209D
Boulder, CO 80301
Phone (303) 752-6711

4710 Table Mesa Dr
Boulder, CO 80305
Phone (303) 499-9892

4710 Table Mesa Dr
Ste B
Boulder, CO 80305
Phone (303) 499-9892

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1184212813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4636 TALBOT DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032620",
            "telephone_number": "313-614-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 TABLE MESA DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803054503",
            "telephone_number": "313-614-3177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4636 Talbot Dr",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803032620",
            "country_code": "US",
            "telephone_number": "313-614-3177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIERRAMAR",
        "first_name": "CHRISTINE",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0016510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.