Brandy L. Shinnick

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSA0203541 Issued in NM

Practice address

01 Sagebrush Street
Isleta, NM 87022

Phone

(505) 869-5475

Fax

(505) 869-4881

NPI assigned

May 15, 2019

Last updated

May 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Brandy L. Wright Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1386200384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "ISLETA",
            "state": "NM",
            "postal_code": "870220640",
            "telephone_number": "505-869-5475",
            "fax_number": "505-869-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "01 SAGEBRUSH STREET",
            "city": "ISLETA",
            "state": "NM",
            "postal_code": "87022",
            "telephone_number": "505-869-5475",
            "fax_number": "505-869-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINNICK",
        "first_name": "BRANDY",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0203541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "WRIGHT",
            "middle_name": "L.",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriel I Rael, LMHC
• John James Richter III, D.D.S.
• Karen Marie Roop, R.D, L.D
• Jennifer Sandoval, LADAC
• Juanita Sena
• Veronica Sprunk, RPH
• Emily J. Stafford, MS, LPCC, LADAC
• Santana M Titla
• Pearlyn Gail Tomosie, M.D.
• Bernadette Valdez, PT

• Addiction (Substance Use Disorder) Counselor in Isleta, NM
• Providers in Isleta, 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 May 15, 2019; 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.