T Wiard LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0109811 Issued in NM

Legal business name

T WIARD LLC

Practice address

125 La Posta Rd Ste B15
Taos, NM 87571-7242

Phone

(505) 690-0126

NPI assigned

Sep 27, 2013

Last updated

Jun 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Theodore John Wiard, LPCCNPI 1790894053

Title

Chief Executive Officer

Phone

(505) 690-0126

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theodore John Wiard, LPCC

  • Mental Health Counselor
  • Taos, NM
  • NPI 1790894053
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1942637517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 569",
            "city": "ARROYO HONDO",
            "state": "NM",
            "postal_code": "87513",
            "telephone_number": "505-690-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LA POSTA RD STE B15",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875717242",
            "telephone_number": "505-690-0126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "07 Callecita",
            "address_purpose": "LOCATION",
            "city": "Arroyo Hondo",
            "state": "NM",
            "postal_code": "87513",
            "country_code": "US",
            "telephone_number": "505-690-0126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "T WIARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "WIARD",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "505-690-0126",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0109811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristin Swim
• Jeniffer Sylvester, RPH
• Andrew F Tafoya, BMS
• Yvonne M Tafoya
• Taos Addiction Treatment Services
• Taos Chiropractic Health Center, Inc
• Taos Clinic for Children and Youth

• Professional Counselor in Taos, NM
• Providers in Taos, 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 Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.