Brenna Fisch

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP7681 Issued in NM

Practice address

3876 Hawkins St NE
Albuquerque, NM 87109-4539

Phone

(505) 508-0865

NPI assigned

Mar 16, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gestalt Speech Therapy

  • Speech-Language Pathologist
  • Albuquerque, NM
  • NPI 1366243958

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1104574383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 11TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3876 HAWKINS ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094539",
            "telephone_number": "505-508-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCH",
        "first_name": "BRENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "SLP7681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Nations Community Healthsource Pharmacy
• First Nations Naca SBHC
• First Resort Interventions, LLC
• Firststeps Autism Evaluations, LLC
• Beverly R Firth, RN, MN, CNS
• Bruce J. Fisch, MD
• Christy Fischer, PHARM D
• Edgar G Fischer, MD
• Kristan Fischer
• Susan Paige Fischer, MA

• Speech-Language Pathologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.