Individual provider Active NPI

Carolyn S Van Housen, LMFT

  • Marriage & Family Therapist
  • Albuquerque, NM
National Provider Identifier
1205190253
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0093041 Issued in NM
Practice address
8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Phone
(505) 291-2134
Fax
(505) 291-2931
NPI assigned
Jun 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0093041 NM Primary

Addresses

Primary practice location

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

Mailing address

25 Vista de Oro
Placitas, NM 87043-9227
Phone (505) 867-3606

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0093041NMMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1205190253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 VISTA DE ORO",
            "city": "PLACITAS",
            "state": "NM",
            "postal_code": "870439227",
            "telephone_number": "505-867-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTITUTION AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107613",
            "telephone_number": "505-291-2134",
            "fax_number": "505-291-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HOUSEN",
        "first_name": "CAROLYN",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "0093041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.