Active NPI
Tara Kathryn Thelen, LMHC
- Mental Health Counselor
- Albuquerque, NM
National Provider Identifier
1881887016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0100161
- Practice address
- 8338 Comanche Rd NE Ste B
Albuquerque, NM 87110-2357 - Phone
- (505) 323-3665
- Fax
- (505) 323-1038
- NPI assigned
- Aug 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0100161 | NM | Primary |
Addresses
Primary practice location
8338 Comanche Rd NE Ste B
Albuquerque, NM 87110-2357
Mailing address
8338 Comanche Rd NE Ste B
Albuquerque, NM 87110-2357
Phone (505) 323-3665
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76804 | Other | PRESBYTERIAN | |
| 10006701 | Other | LOVELACE | |
| NM00JB93 | Other | NM | BCBS |
| 34083260 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0100161 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Life Center for Family Development | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Albuquerque, NM
- NPI 1437164811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187654400000",
"number": "1881887016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8338 COMANCHE RD NE STE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871102357",
"telephone_number": "505-323-3665",
"fax_number": "505-323-1038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8338 COMANCHE RD NE STE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871102357",
"telephone_number": "505-323-3665",
"fax_number": "505-323-1038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THELEN",
"first_name": "TARA",
"middle_name": "KATHRYN",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-21",
"last_updated": "2007-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0100161",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN",
"identifier": "76804",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE",
"identifier": "10006701",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "NM00JB93",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34083260",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.