The Roots Counseling Center

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0180421 Issued in NM

Legal business name

THE ROOTS COUNSELING CENTER

Practice address

310 N Broadway St
Truth Or Consequences, NM 87901-2834

Phone

(575) 297-0171

Fax

(575) 288-2806

NPI assigned

May 20, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Sherilyn Marie Oberlin, LPCC

Title

Owner

Phone

(575) 297-0171

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Jane Dyke, LCSW

  • Clinical Social Worker
  • Truth Or Consequences, NM
  • NPI 1184177131
  NPD (past)

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1861849754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N BROADWAY ST",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879012834",
            "telephone_number": "575-297-0171",
            "fax_number": "575-288-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N BROADWAY ST",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879012834",
            "telephone_number": "575-297-0171",
            "fax_number": "575-288-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ROOTS COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "OBERLIN",
        "authorized_official_first_name": "SHERILYN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-297-0171",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0180421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81985363",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sarah Thayer, LMSW
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• Mary Dolores Tyll, PHD ABPP MSCP
• VCG New Mexico LLC
• Nichelle Amber Vigil, APRN-CNP
• Wal-Mart Stores East LP

• Professional Counselor in Truth Or Consequences, NM
• Providers in Truth Or Consequences, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.