Individual provider Active NPI

Pamela Mauldin Tomlin, LPCC

  • Mental Health Counselor
  • Ruidoso, NM
National Provider Identifier
1194966259
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CTB20230316 Issued in NM
Practice address
1400 Sudderth Dr
Ruidoso, NM 88345
Phone
(575) 630-0571
NPI assigned
Mar 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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 CTB20230316 NM Primary

Addresses

Primary practice location

1400 Sudderth Dr
Ruidoso, NM 88345

Mailing address

1400 Sudderth Dr
Ruidoso, NM 88345-6103
Phone (575) 630-0571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409000266 NM Practitioner - Mental Health Counselor 8729426945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Practice addresses (Care Compare)

1501 10TH St
Alamogordo, NM 88310-5044
Phone (575) 434-2960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CTB20230316NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services CurrentSince Feb 20, 2024 Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Presbyterian Medical Services CurrentSince Feb 20, 2024 Accepting new patients

Locations

1501 10th St
Alamogordo, NM 88310
Phone (505) 443-8133

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1194966259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SUDDERTH DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456103",
            "telephone_number": "575-630-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SUDDERTH DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "88345",
            "telephone_number": "575-630-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLIN",
        "first_name": "PAMELA",
        "middle_name": "MAULDIN",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB20230316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruidoso, NM

Sources for this page

Verify at the official NPI Registry.