NPIMap

Individual provider Active NPI

Tara Bremer Quintana, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1184978579
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
M-08082 Issued in NM
Practice address
11930 Menaul Blvd NE Ste 101a
Albuquerque, NM 87112-2478
Phone
(505) 453-5089
NPI assigned
Nov 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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 M-08082 NM Primary

Addresses

Primary practice location

11930 Menaul Blvd NE Ste 101a
Albuquerque, NM 87112-2478

Mailing address

11930 Menaul Blvd NE Ste 101a
Albuquerque, NM 87112-2478
Phone (505) 453-5089

Other names 1

  • Tara Marie Bremer Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M-08082NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Strength Mental Health and Wellness, LLC Clinical Past Accepting new patients

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": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1184978579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11930 MENAUL BLVD NE STE 101A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122478",
            "telephone_number": "505-453-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 MENAUL BLVD NE STE 101A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122478",
            "telephone_number": "505-453-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA",
        "first_name": "TARA",
        "middle_name": "BREMER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "M-08082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "BREMER",
            "middle_name": "MARIE",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.