Carson Am Tabiolo

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-2059 Issued in HI

Practice address

Meddac-Bavaria
PSC 411 Unit 28037
Apo, AE 09112

Phone

(314) 590-3878

NPI assigned

Aug 12, 2015

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 23, 2026 through Jan 23, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hale Kipa, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ewa Beach, HI
  • NPI 1164627246

  Mental Health

  NPD (past)
• Hawaii Center for Children and Families, LLC

  • Counseling Psychologist
  • Kapolei, HI
  • NPI 1194163253
  NPD (past)
• Hope & Healing Counseling Center, PLLC

  dba Hope & Healing Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jenison, MI
  • NPI 1568198935
  NPD (past)

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1932575941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "MEDDAC-BAVARIA",
            "address_2": "PSC 411 UNIT 28037",
            "city": "APO",
            "state": "AE",
            "postal_code": "09112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "MEDDAC-BAVARIA",
            "address_2": "PSC 411 UNIT 28037",
            "city": "APO",
            "state": "AE",
            "postal_code": "09112",
            "telephone_number": "314-590-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABIOLO",
        "first_name": "CARSON",
        "middle_name": "AM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC849",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-2059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.