David Eaton Bragg, LISW
Individual provider Active NPI Social Worker · Deming, NM
NPI 1518062991 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1518062991
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- I05272 (NM)
- Practice address
- 901 W Hickory
Deming, NM 88030 - Phone
- (505) 546-2174
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Mexico Health Options | Past | Accepting new patients | |
| Border Area Mental Health Services, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | I05272 | NM | Yes |
Addresses
Primary practice location
901 W Hickory
Deming, NM 88030
Mailing address
PO Box 1349
Silver City, NM 88062
Phone (505) 546-2174
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 75184281 | Medicaid | NM |
Other providers in Deming, NM
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.