Shanna Cullen-Carroll, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T-CTL0212371 Issued in NM

Practice address

100 Sun Ave NE Ste 650
Albuquerque, NM 87109-4670

Phone

(909) 790-8603

Fax

(909) 790-8618

NPI assigned

Mar 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1730211715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SUN AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094659",
            "telephone_number": "505-376-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SUN AVE NE STE 650",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094670",
            "telephone_number": "909-790-8603",
            "fax_number": "909-790-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN-CARROLL",
        "first_name": "SHANNA",
        "name_prefix": "Miss",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49429",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "T-CTL0212371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "330489658",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raven Elizabeth Cuellar, PH. D.
• Briana Cuestas
• Lizeth Rocio Cueto-Salgado
• Amy L Cuff, M.D.
• Cuidando Los Ninos, Inc
• Chandra Cullen
• Petra Cullen
• Robin Cullen
• Laurie Cullinan, SLP
• Robert Douglas Culling, DO

• Marriage & Family Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Marriage & Family Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.