Theodore John Wiard, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0109811 Issued in NM

Practice address

125 La Posta Rd Ste B15
Taos, NM 87571-7242

Phone

(505) 690-0126

NPI assigned

Aug 30, 2006

Last updated

May 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Red Willow Hospice

  • Community Based Hospice Care Agency
  • Taos, NM
  • NPI 1114656642

  5% Or Greater Direct Ownership Interest

  CMS ownership

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.

• T Wiard LLC

  • Professional Counselor
  • Taos, NM
  • NPI 1942637517
  Medicare reassignment NPD Authorized official
• Golden Willow Counseling LLC

  • Community/Behavioral Health Agency
  • Taos, NM
  • NPI 1346786902
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1790894053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 SIPAPU ST",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716498",
            "telephone_number": "505-690-0126",
            "fax_number": "575-586-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LA POSTA RD STE B15",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875717242",
            "telephone_number": "505-690-0126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "07 Callecita",
            "address_purpose": "LOCATION",
            "city": "Arroyo Hondo",
            "state": "NM",
            "postal_code": "87513",
            "country_code": "US",
            "telephone_number": "505-690-0126",
            "fax_number": "575-586-1259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIARD",
        "first_name": "THEODORE",
        "middle_name": "JOHN",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NM",
            "license": "0109811",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0109811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Whipple, LADAC
• White Crane Clinic, P.a.
• Camille White
• Robert B White
• Sandra W Whitney
• Kristin Wight
• Winston Wilde, MFC
• Page Willauer, DOULA
• Amy Williams, LPCC, CCFC
• Charles M Williams

• Mental Health Counselor in Taos, NM
• Providers in Taos, 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 May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.