Golden Willow Counseling LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GOLDEN WILLOW COUNSELING LLC

Practice address

412 Sipapu St
Taos, NM 87571-6498

Phone

(575) 770-9513

NPI assigned

Jan 6, 2017

Organization subpart

No

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

Authorized official

Name

Lawrence A Medina, MBA

Title

Practice Manager

Phone

(505) 470-2887

Specialties & licenses 2

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana L Vigil

  • Case Manager/Care Coordinator
  • Taos, NM
  • NPI 1417565649
  NPD
• Theodore John Wiard, LPCC

  • Mental Health Counselor
  • Taos, NM
  • NPI 1790894053
  NPD
• Katherine M Worman, FSS

  • Mental Health Counselor
  • Taos, NM
  • NPI 1326271768
  NPD

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1346786902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 SIPAPU ST",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716498",
            "telephone_number": "505-690-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 SIPAPU ST",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716498",
            "telephone_number": "575-770-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN WILLOW COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "505-470-2887",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meri Paige Gerling, MD
• Aline Gittleman
• Calvin Benjamin Glidden III, PT, DPT, LAT, ATC
• Debbie Kay Gober, CASE MANAGER
• Aileen Godat
• Adam Gonzales
• Areli David Gonzales Jr., LADAC
• Arthur Gonzales
• Jacob M Gonzales, PHARM.D.
• Kayla A Gonzales, PT DPT

• Community/Behavioral Health Agency in Taos, NM
• Providers in Taos, NM by specialty
• Community/Behavioral Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.