THERESA J. PAUL (NPI# 1356874267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356874267 |
| Entity Type | Individual |
| Full Name | THERESA J. PAUL |
| Credential | LADAC |
| Practice Address |
Hwy 491 N. Pinon St. Shiprock NM 87420-1830 |
| Mailing Address |
Po Box 1830 Shiprock NM 87420-1830 |
| Practice Telephone | 5053681438 |
| Practice Fax Number | 5053681452 |
| Mailing Telephone | 5053681438 |
| Mailing Fax Number | 5053681452 |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2019-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0178601 | NM | Behavioral Health & Social Service Providers |
| Street Address |
HWY 491 N. PINON ST. |
| City | SHIPROCK |
| State | NM |
| Zip Code | 87420-1830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962731786 | Jerry Wilson | Counselor | Hwy 491 N. Pinon St., Red Modular Bldg, Shiprock, NM 87420-1830 | 2009-12-08 |
| 1174876296 | Amanda M Lobato | Counselor | Hwy 491 N. Pinon St., Shiprock, NM 87420 | 2012-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003424383 | Ciara Hansen | Psychologist | Us- 491, Shiprock, NM 87420 | 2020-07-22 |
| 1013540848 | Kelsi Marie Hartwig | Dental Hygienist | Highway 491 North, Yucca Street, Shiprock, NM 87420 | 2020-02-20 |
| 1194364232 | Maria Sturtz | Pharmacist | Us Why 491 North, Shiprock, NM 87420 | 2020-01-06 |
| 1811533979 | Merissa Jo De La Garza | Pharmacist | Highway 491 S, Shiprock, NM 87420 | 2019-11-25 |
| 1619528510 | Heather Scott | Psychologist | Highway 64, Old High School Road, Shiprock, NM 87420 | 2019-09-23 |
| 1396305264 | Malaura Creager | Pharmacist | North Hwy 491, Shiprock, NM 87420 | 2019-06-13 |
| 1275011488 | Dawn Fowler | Registered Nurse | Us Highway 64, Shiprock, NM 87420 | 2018-07-31 |
| 1902384373 | Brittany Jones | Occupational Therapy Assistant | Us 64, Old High School Rd., Shiprock, NM 87420 | 2018-07-30 |
| 1528561701 | Patricia D Suarez | Registered Nurse | Central Consolidated School of New Mexico, Hwy 64, Old High School Road, Shiprock, NM 87420 | 2018-03-14 |
| 1023549284 | Ellen Liversidge | Speech-Language Pathologist | Hwy 64, Old High School Rd., Shiprock, NM 87420 | 2017-03-21 |
| Find all providers in zip 87420 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306147038 | James Albert Begay | Counselor | Hwy 491 N Pinon Street Red Moudular Bldg, Shiprock, NM 87420-1830 | 2010-11-11 |
| 1669702932 | Sidney Ann Brown | Counselor | Pinon & Cottonwood Dr, Building #2301, Shiprock, NM 87401 | 2010-01-07 |
| 1962731786 | Jerry Wilson | Counselor | Hwy 491 N. Pinon St., Red Modular Bldg, Shiprock, NM 87420-1830 | 2009-12-08 |
| 1033329057 | Gerald Natoni Garnenez | Counselor | Dorm #2 Yucca Street, Shiprock, NM 87420 | 2007-05-22 |
| 1972713899 | Delbert John | Counselor | Hwy 491 North Pinion Street, Shiprock, NM 87420 | 2007-05-22 |
| 1205043197 | Arminda M. Williams | Counselor | Hwy 491 N., Pinon St., Shiprock, NM 87420 | 2007-05-17 |
| 1609083468 | Wanda Mae Westbrook | Counselor | Hwy 491 N, Pinon Street, Shiprock, NM 87420 | 2007-05-17 |
| 1487876991 | Navajo Regional Behavioral Health Center - Outpatient | Counselor | Pinon & Cottonwood Dr Building #2301, Shiprock, NM 87420 | 2007-05-03 |
| 1821641986 | Luanita Marie Etsity | Counselor | Hwy 491 North Pinon Street, Shiprock, NM 87420-1830 | 2019-07-18 |
| 1619529047 | Harrison R. Dokey | Counselor | Hwy 491 North Pinon Street, Shiprock, NM 87420 | 2019-07-16 |
| Find all providers in SHIPROCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.