Mary Susan Tieden

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

293 Issued in AK

Practice address

201 North Nordic Drive
Petersburg, AK 99833

Phone

(907) 772-3332

Fax

(888) 858-8850

NPI assigned

Feb 18, 2010

Last updated

Feb 18, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/raincountry/r4/

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.

• Petersburg Mental Health Services

  • Social Worker
  • Petersburg, AK
  • NPI 1922443969
  NPD (past)
• Petersburg Mental Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Petersburg, AK
  • NPI 1174690309
  NPD (past)

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1508188582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998331309",
            "telephone_number": "907-772-3332",
            "fax_number": "888-858-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NORTH NORDIC DRIVE",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "99833",
            "telephone_number": "907-772-3332",
            "fax_number": "888-858-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDEN",
        "first_name": "MARY",
        "middle_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH1413",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Lemiere Taylor, LMSW
• The Petersburg Medical Center
• The Petersburg Medical Center
• The Petersburg Medical Center
• The Petersburg Medical Center
• Mark W Tuccillo, DO
• Becky Ann Turland
• Julie Walker
• Mark Walker, LCSW
• Suzanne Webb, MT

• Mental Health Counselor in Petersburg, AK
• Providers in Petersburg, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.