Brenda Ann Tanguma, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSA0214911 Issued in NM

Practice address

630 Haines Ave NW
Albuquerque, NM 87102-1226

Phone

(505) 268-5611

Fax

(505) 268-5736

NPI assigned

Jan 13, 2021

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

Electronic endpoints 1

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.

• Metro Treatment of New Mexico LP

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1144437294
  NPD (past)
• Metro Treatment of New Mexico LP

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1710512199
  NPD (past)

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1366031411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 HAINES AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021226",
            "telephone_number": "505-268-5611",
            "fax_number": "505-268-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 HAINES AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021226",
            "telephone_number": "505-268-5611",
            "fax_number": "505-268-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGUMA",
        "first_name": "BRENDA",
        "middle_name": "ANN",
        "credential": "LSAA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0214911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brenda.tanguma@cmglp.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "630 Haines Ave NW",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871021226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Allen Tan, OT
• Leilani Kiyoko Tanaka, DDS
• William Daniel Tandberg, MD
• Sharon Gail Tandy, SLP
• Anjali Taneja, MD, MPH
• Kathryn Tanis, CNP
• Marianne Tank
• Elizabeth Tannaz
• Lisa Tannen
• Barbara Dawn Tanner-Torres, ACNP-BC

• Addiction (Substance Use Disorder) Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.