Brandy L. Shinnick

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Isleta, NM

NPI 1386200384 · NPPES record last updated May 15, 2019

Key facts

NPI
1386200384
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CSA0203541 (NM)
Practice address
01 Sagebrush Street
Isleta, NM 87022
Phone
(505) 869-5475
Fax
(505) 869-4881
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CSA0203541NMMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CSA0203541 NM Yes

Addresses

Primary practice location

01 Sagebrush Street
Isleta, NM 87022

Mailing address

PO Box 640
Isleta, NM 87022-0640
Phone (505) 869-5475

Other names

  • Miss Brandy L. Wright Former name

Other providers in Isleta, NM

All providers in Isleta, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.