Individual provider Active NPI

Mareike Tenberge Budo, LPC. ESMHL. CTRI. RM

  • Mental Health Counselor
  • Metairie, LA
National Provider Identifier
1912591710
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8448 Issued in LA
Practice address
4300 S I 10 Service Rd W Ste 117
Metairie, LA 70001-7427
Phone
(504) 841-0007
NPI assigned
Feb 23, 2021
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8448 LA Primary

Addresses

Primary practice location

4300 S I 10 Service Rd W Ste 117
Metairie, LA 70001-7427

Mailing address

4224 S Rocheblave St
New Orleans, LA 70125-4549
Phone (504) 715-8251

Other identifiers 1

IdentifierTypeStateIssuer
1881909042MedicaidLA

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
8448LAMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1912591710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 S ROCHEBLAVE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701254549",
            "telephone_number": "504-715-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 S I 10 SERVICE RD W STE 117",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700017427",
            "telephone_number": "504-841-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDO",
        "first_name": "MAREIKE",
        "middle_name": "TENBERGE",
        "credential": "LPC. ESMHL. CTRI. RM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "8448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881909042",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.