Individual provider Active NPI

Tammy Fellows, LMHC

  • Mental Health Counselor
  • Clovis, NM
National Provider Identifier
1376714246
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
T-0111211 Issued in NM
Practice address
1600 Sutter PL
Clovis, NM 88101-4611
Phone
(575) 769-4490
Fax
(575) 935-0011
NPI assigned
Mar 18, 2008
Last updated
Mar 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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 T-0111211 NM Primary

Addresses

Primary practice location

1600 Sutter PL
Clovis, NM 88101-4611

Mailing address

1600 Sutter PL
Clovis, NM 88101-4611
Phone (575) 769-4490

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
I20240513000633 NM Practitioner - Mental Health Counselor 2264873934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Healing TherapyGroup PAC ID 0446699748, 2 clinicians

Practice addresses (Care Compare)

2019 Galisteo St
Suite N5
Santa Fe, NM 87505-2111
Phone (505) 693-6132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T-0111211NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Healing Therapy Mental Health CurrentSince Apr 25, 2024 Accepting new patients
Clovis Municipal Schools Past Accepting new patients

Locations

2019 Galisteo St
Ste N5
Santa Fe, NM 87505
Phone (505) 693-6132

Organizations & group practices 2

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": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1376714246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SUTTER PL",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014611",
            "telephone_number": "575-769-4490",
            "fax_number": "575-935-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SUTTER PL",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014611",
            "telephone_number": "575-769-4490",
            "fax_number": "575-935-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLOWS",
        "first_name": "TAMMY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T-0111211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.