Individual provider Active NPI

Jenna Brimmer, LMSW

  • Social Worker
  • Albuquerque, NM
National Provider Identifier
1477098838
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M-11051 Issued in NM
Practice address
2612 Texas St NE
Albuquerque, NM 87110-4684
Phone
(505) 830-1871
NPI assigned
Dec 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X M-11051 NM
Social Worker 104100000X M-11051 NM Primary

Addresses

Primary practice location

2612 Texas St NE
Albuquerque, NM 87110-4684

Mailing address

2221 Rio Grande Blvd NW
Albuquerque, NM 87104-2529
Phone (505) 830-1871

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
I20240103004622 NM Practitioner - Mental Health Counselor 7214388230 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
GD Psych Services, LLCGroup PAC ID 6204260474, 18 clinicians

Practice addresses (Care Compare)

2200 Grande Blvd SE
Suite B
Rio Rancho, NM 87124-1695
Phone (505) 218-6383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M-11051NMMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Families of Albuquerque LLC CurrentSince Jan 1, 2024 Accepting new patients
GD Psych Services, LLC Counselor CurrentSince Jul 20, 2024 Accepting new patients
Peanut Butter and Jelly Family Services Past Accepting new patients

Locations

1803 Carlisle Blvd NE
Albuquerque, NM 87110
Phone (505) 842-9911

2200 Grande Blvd SE
Ste B
Rio Rancho, NM 87124
Phone (505) 218-6383

Organizations & group practices 3

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": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1477098838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 RIO GRANDE BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042529",
            "telephone_number": "505-830-1871",
            "fax_number": "505-830-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 TEXAS ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104684",
            "telephone_number": "505-830-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIMMER",
        "first_name": "JENNA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NM",
            "license": "M-11051",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-11051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.