NPIMap

Organization Active NPI

Bradford C. Richards

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Albuquerque, NM
National Provider Identifier
1609979608
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
#0855 Issued in NM
Legal business name
BRADFORD C. RICHARDS
Practice address
1 San Rafael Avenue NE
Albuquerque, NM 87122
Phone
(505) 823-1600
Fax
(505) 823-1161
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Authorized official

Name
Dr. Bradford C. Richards, PH.D.NPI 1114031820
Title
Doctor/Owner
Phone
(505) 823-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X PSYCHOLOGIST #0855 NM
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X #0855 NM Primary

Addresses

Primary practice location

1 San Rafael Avenue NE
Albuquerque, NM 87122

Mailing address

1 San Rafael Avenue NE
Albuquerque, NM 87122
Phone (505) 823-1600

Other identifiers 2

IdentifierTypeStateIssuer
2473804MedicaidNM
24738034MedicaidNM

Other names 1

  • Cognitive Behavioral Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091016000174 NM Part B Supplier - Clinic/Group Practice 0446397855 Receives reassigned benefits from 4 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

1 San Rafael Ave NE
Albuquerque, NM 87122
Phone (505) 823-1600

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1609979608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAN RAFAEL AVENUE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87122",
            "telephone_number": "505-823-1600",
            "fax_number": "505-823-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAN RAFAEL AVENUE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87122",
            "telephone_number": "505-823-1600",
            "fax_number": "505-823-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD C. RICHARDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "505-823-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NM",
            "license": "PSYCHOLOGIST #0855",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NM",
            "license": "#0855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2473804",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24738034",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cognitive Behavioral Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.