Individual provider Active NPI

Carmen Ulloa, MS. ED

  • Professional Counselor
  • Flagstaff, AZ
National Provider Identifier
1649426149
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-12455 Issued in AZ
Practice address
400 W Elm Ave
Flagstaff, AZ 86001-1562
Phone
(928) 773-8100
Fax
(928) 773-8146
NPI assigned
Aug 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-12455 AZ Primary

Addresses

Primary practice location

400 W Elm Ave
Flagstaff, AZ 86001-1562

Mailing address

3285 E Sparrow Ave
Flagstaff, AZ 86004-7794
Phone (928) 527-6163

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
LPC-12455AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Unified School District #1 Past Accepting new patients
Flagstaff Unified School District Past Accepting new patients

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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1649426149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 E SPARROW AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047794",
            "telephone_number": "928-527-6163",
            "fax_number": "925-527-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W ELM AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011562",
            "telephone_number": "928-773-8100",
            "fax_number": "928-773-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOA",
        "first_name": "CARMEN",
        "credential": "MS. ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-12455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.