Lupe E Bryan
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bernalillo, NM
NPI 1316100175 · NPPES record last updated Jul 2, 2008
Key facts
- NPI
- 1316100175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 67352 (NM)
- Practice address
- 1043 Hwy 313
Bernalillo, NM 87004-6912 - Phone
- (505) 867-3351
- Fax
- (505) 867-3514
- NPI assigned
- Jul 2, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67352 | NM | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Five Sandoval Indian Pueblos, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 67352 | NM | Yes |
Addresses
Primary practice location
1043 Hwy 313
Bernalillo, NM 87004-6912
Mailing address
1043 Hwy 313
Bernalillo, NM 87004-6912
Phone (505) 867-3351
Other providers in Bernalillo, NM
- Monique Umlas Betz
- Madisen Bihn-Adams
- Mary Webster Birch
- Gwendolyn Michelle Blueeyes
- Charlotte Branson
- Aubrie Bushaw
- Erica Butler
- Miriam R. Buysse
- Angela Elizabeth Campbell
- Rebecca Casalino
All providers in Bernalillo, NM · Addiction (Substance Use Disorder) Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.