Tamara Suzanne Bibo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0067282 Issued in NM

Practice address

2543 Wyoming Blvd NE
Albuquerque, NM 87112-1037

Phone

(505) 294-3900

Fax

(505) 294-3904

NPI assigned

Dec 3, 2013

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 names 1

• Tamara Suzanne Marcelain Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Life Change Institute, LLC.

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1962731174
  NPD (past)

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1700217601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2170",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870592170",
            "telephone_number": "505-350-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2543 WYOMING BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121037",
            "telephone_number": "505-294-3900",
            "fax_number": "505-294-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBO",
        "first_name": "TAMARA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0067282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "MARCELAIN",
            "middle_name": "SUZANNE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Bianco, M.A.
• Rosa Bias, CPSW
• Gary J. Biazak, M.D.
• Robert A Biazak, M.D.
• Robert Bibeau, DOM
• Amy Bickel, PHARMD
• Carol J. Bickelman, LPCC
• Joseph M. Bicknell, MD
• Pamela Louise Bicknell, APRN-CNP
• Samantha Jean Bicknell

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.