MRS. TARA SUE OLGUIN


Address: 11930 Menaul Blvd Ne Ste 221d, Albuquerque, NM 87112-2465
Phone: 5053211345

MRS. TARA SUE OLGUIN (NPI# 1619115433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619115433
Entity Type Individual
Full Name MRS. TARA SUE OLGUIN
Credential LPCC
Practice Address 11930 Menaul Blvd Ne Ste 221d
Albuquerque
NM 87112-2465
Practice Telephone 5053211345
Practice Fax Number 5052942922
Mailing Telephone 5053211345
Mailing Fax Number 5052942922
Enumeration Date 2009-02-02
Last Update Date 2009-02-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
T-0118271 NM Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NM MEDICAID NUMBER DD WAIVER 06557023 01

Office Location

Street Address 11930 MENAUL BLVD NE STE 221D
City ALBUQUERQUE
State NM
Zip Code 87112-2465

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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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Competitor

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City ALBUQUERQUE
Zip Code 87112

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Dataset Information

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.

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