Individual provider Active NPI

Brian M Mabary

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1053953547
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2024-0256 Issued in NM
Practice address
1101 Medical Arts Ave NE BLDG 3
Albuquerque, NM 87102-2722
Phone
(505) 933-4639
NPI assigned
Oct 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2024-0256 NM Primary

Addresses

Primary practice location

1101 Medical Arts Ave NE BLDG 3
Albuquerque, NM 87102-2722

Mailing address

1101 Medical Arts Ave NE BLDG 3
Albuquerque, NM 87102-2722
Phone (505) 933-4639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240911003001 NM Practitioner - Clinical Social Worker 5890235212 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SWB-2024-0256NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Small Steps Child Counseling, LLC Mental Health CurrentSince Aug 20, 2024 Accepting new patients

Locations

1101 Medical Arts Ave NE
Bldg 3
Albuquerque, NM 87102
Phone (505) 842-5300

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1053953547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL ARTS AVE NE BLDG 3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022722",
            "telephone_number": "505-933-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL ARTS AVE NE BLDG 3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022722",
            "telephone_number": "505-933-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABARY",
        "first_name": "BRIAN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-16",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2024-0256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.