Alfred B. Carmack, LMHC – Mental Health Counselor

Key facts

NPI: 1891709234
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
License: 0080291 (NM)
Practice address: 313 Sedillo Hill Rd
Tijeras, NM 87059-7389
Phone: (505) 265-1711
NPI assigned: Jul 29, 2006
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
0080291	NM	MD	Mental Health Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X	0080291	NM	Yes

Addresses

Primary practice location

313 Sedillo Hill Rd
Tijeras, NM 87059-7389

Mailing address

313 Sedillo Hill Rd
Tijeras, NM 87059-7389
Phone (505) 265-1711

Other identifiers

Identifier	Type	State	Issuer
0080291	Other	NM	LMHC

Other names

Fred Carmack Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891709234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 SEDILLO HILL RD",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870597389",
            "telephone_number": "505-265-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 SEDILLO HILL RD",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870597389",
            "telephone_number": "505-265-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMACK",
        "first_name": "ALFRED",
        "middle_name": "B.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0080291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC",
            "identifier": "0080291",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRED",
            "last_name": "CARMACK",
            "credential": "LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tijeras, NM

All providers in Tijeras, NM · Mental Health Counselor in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.