Individual provider Active NPI

Bryan D Norman, LCSW

  • Clinical Social Worker
  • Rio Rancho, NM
National Provider Identifier
1477064962
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-08661 Issued in NM
Practice address
6032 Redondo Sierra Vis NE
Rio Rancho, NM 87144-0606
Phone
(703) 945-4535
NPI assigned
Oct 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C-08661 NM Primary

Addresses

Primary practice location

6032 Redondo Sierra Vis NE
Rio Rancho, NM 87144-0606

Mailing address

6032 Redondo Sierra Vis NE
Rio Rancho, NM 87144-0606
Phone (703) 945-4535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180213000762 NM Practitioner - Clinical Social Worker 2365702347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6032 Redondo Sierra Vis NE
Rio Rancho, NM 87144-0606
Phone (703) 945-4535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-08661NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Numinous Counseling and Wellness, LLC CurrentSince May 1, 2020 Accepting new patients

Locations

3900 Juan Tabo Blvd NE
Albuquerque, NM 87111
Phone (505) 275-6406

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1477064962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6032 REDONDO SIERRA VIS NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871440606",
            "telephone_number": "703-945-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6032 REDONDO SIERRA VIS NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871440606",
            "telephone_number": "703-945-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "BRYAN",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-24",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-08661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.