Passionate Minds Behavioral Health LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PASSIONATE MINDS BEHAVIORAL HEALTH LLC

Practice address

185 Osprey CT
Santa Teresa, NM 88008-9502

Phone

(915) 701-6864

NPI assigned

May 21, 2024

Last updated

May 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Bryan, LCSWNPI 1679184147

Title

Owner

Phone

(915) 701-6864

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Christopher Bryan, LCSW

  • Clinical Social Worker
  • Santa Teresa, NM
  • NPI 1679184147
  NPD Authorized official

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1205675154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 OSPREY CT",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089502",
            "telephone_number": "915-701-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 OSPREY CT",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089502",
            "telephone_number": "915-701-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSIONATE MINDS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-701-6864",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscilla Ortega
• Nasser Emilio Ortiz
• Vanessa X Ortiz, MA
• Noha Oushy Eissa, DDS
• Megan Noelle Parker
• Peak Behavioral Health
• Peak Behavioral Health Services LLC
• Annissa Danielle Pellicano
• Marcos Pena, LCSW, LADAC
• Rosa Irma Pennington

• Clinical Social Worker in Santa Teresa, NM
• Providers in Santa Teresa, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.