Therapeutic Living Services, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THERAPEUTIC LIVING SERVICES, INC.

Practice address

5601 Domingo Rd NE
Albuquerque, NM 87108-1610

Phone

(505) 268-5295

Fax

(505) 268-9967

NPI assigned

Jan 16, 2007

Last updated

Feb 10, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Barbara L Church, LPPCNPI 1942433636

Title

Executive Director

Phone

(505) 268-5295

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316098346. Details of each certification follow.

• CCN 324623 Community mental health center · Active · Name & address match · Details

Community mental health center certification: CCN 324623

Legal name

THERAPEUTIC LIVING SERVICES INC

Certification status

Active

Provider type (POS)

Community mental health center

Participating since

Sep 24, 2013

Last certification

Sep 24, 2013

Ownership / control type

For profit – corporation

Facility address

5601 Domingo Road NE
Albuquerque, NM 87108

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barbara L Church, LPCC

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1942433636
  Authorized official Same address or phone

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1316098346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 DOMINGO RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081610",
            "telephone_number": "505-268-5295",
            "fax_number": "505-268-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 DOMINGO RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081610",
            "telephone_number": "505-268-5295",
            "fax_number": "505-268-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC LIVING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-268-5295",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B9311",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Kathryn Thelen, LMHC
• Themis Training and Consulting LLC (Thunderbird Rising Recovery)
• Theodore L Varoz DPM
• Kai Marie Theophilus, LMT
• Therapeutic Innovations Physical Therapy, Inc.
• Therapeutic Massage Associates, LLC
• Therapeutic Roots Behavioral Health (Michelle Sanderson)
• Therapy Advocacy & Outreach Inc
• Therapy Consultants of New Mexico
• Bethany Elizabeth Theus, MS, CCC-SLP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.