NPIMap

Individual provider Active NPI

Carl J Shearer, LPCC

  • Mental Health Counselor
  • Las Vegas, NM
National Provider Identifier
1770812349
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
T-0123421 Issued in NM
Practice address
700 Friedman Ave
Las Vegas, NM 87701-4231
Phone
(505) 454-5100
Fax
(505) 454-0397
NPI assigned
Dec 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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-0123421 NM Primary

Addresses

Primary practice location

700 Friedman Ave
Las Vegas, NM 87701-4231

Mailing address

3695 Hot Springs Blvd
Las Vegas, NM 87701-9549
Phone (505) 454-2100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
T-0123421NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
El Centro Family Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1770812349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3695 HOT SPRINGS BLVD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877019549",
            "telephone_number": "505-454-2100",
            "fax_number": "505-454-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 FRIEDMAN AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014231",
            "telephone_number": "505-454-5100",
            "fax_number": "505-454-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "CARL",
        "middle_name": "J",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T-0123421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.