Individual provider Active NPI

Carol Y Gachupin, LDAC

  • Addiction (Substance Use Disorder) Counselor
  • Jemez Pueblo, NM
National Provider Identifier
1811048820
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
3782 Issued in NM
Practice address
110 Sheep Springs
Jemez Pueblo, NM 87024
Phone
(505) 834-7258
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3782 NM Primary

Addresses

Primary practice location

110 Sheep Springs
Jemez Pueblo, NM 87024

Mailing address

PO Box 451
Jemez Pueblo, NM 87024
Phone (505) 834-7746

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
3782NMMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811048820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451",
            "city": "JEMEZ PUEBLO",
            "state": "NM",
            "postal_code": "87024",
            "telephone_number": "505-834-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SHEEP SPRINGS",
            "city": "JEMEZ PUEBLO",
            "state": "NM",
            "postal_code": "87024",
            "telephone_number": "505-834-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GACHUPIN",
        "first_name": "CAROL",
        "middle_name": "Y",
        "credential": "LDAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "3782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jemez Pueblo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.