Brenda Dee Tanner, LPC
Individual provider Active NPI Mental Health Counselor · Clayton, NM
NPI 1366596363 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366596363
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- T-0099551 (NM)
- Practice address
- 103 Walnut St
Clayton, NM 88415-3049 - Phone
- (505) 374-2032
- Fax
- (505) 374-0158
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| T-0099551 | NM | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | T-0099551 | NM | Yes |
Addresses
Primary practice location
103 Walnut St
Clayton, NM 88415-3049
Mailing address
PO Box 773
Stratford, TX 79084-0773
Phone (214) 202-0485
Other providers in Clayton, NM
- Regina Lynn Siebers
- Silverstone Healthcare of Clayton, LLC
- Christina J. Sisneros
- Southwest Family Medical Care, Inc.
- Jason A. Stroope
- Teambuilders Behavioral Health, LLC
- Town of Clayton
- Alexandria Trujillo
- Jayme Shelly Trujillo
- Krista R. Trujillo
All providers in Clayton, NM · Mental Health 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 8, 2007. 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.