Provider Demographics
NPI:1790822328
Name:KARO, TIMOTHY (LAADAC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:KARO
Suffix:
Gender:M
Credentials:LAADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 POPPY PL
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-2162
Mailing Address - Country:US
Mailing Address - Phone:650-270-3806
Mailing Address - Fax:
Practice Address - Street 1:1600 SAINT MICHAELS DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7615
Practice Address - Country:US
Practice Address - Phone:505-570-5640
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 101Y00000X, 101YA0400X
NMCAD0196121101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No251B00000XAgenciesCase Management
No101Y00000XBehavioral Health & Social Service ProvidersCounselor