Amy Brashear LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0095411 Issued in NM

Legal business name

AMY BRASHEAR LLC

Practice address

12805 Menaul Blvd NE
Albuquerque, NM 87112-2547

Phone

(505) 850-9419

NPI assigned

Jul 17, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Amy Terrell Brashear, MC, M. DIV.

Title

Owner

Phone

(505) 850-9419

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1063767945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12404 TULAROSA TRL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871117275",
            "telephone_number": "505-850-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122547",
            "telephone_number": "505-850-9419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY BRASHEAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "BRASHEAR",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "TERRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-850-9419",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MC, M. DIV."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": "0095411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19973748",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Community/Behavioral Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.