Marythelma Brainard, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

369 Issued in NM

Practice address

2128 Silver Ave SE
Albuquerque, NM 87106-4010

Phone

(505) 242-7671

NPI assigned

Dec 7, 2006

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

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124187075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 10TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871071114",
            "telephone_number": "505-242-7671",
            "fax_number": "505-242-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 SILVER AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064010",
            "telephone_number": "505-242-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAINARD",
        "first_name": "MARYTHELMA",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NM",
            "license": "369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N6580",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Bragg
• Gagandeep Singh Brah, MD
• Brain & Body Rehabilitation Psychotherapy LLC
• Brain and Behavioral Associates, PC
• Brain Injury Association of New Mexico
• Allen Wade Braithwaite, LMT
• Jens Brakenhoff, LMHC
• Artemio D Brambila, PHD
• Emily Kate Brammer, BCBA
• Felicia Heather Branch, FNP-C

• Counseling Psychologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Counseling Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.