Annalissa Spellbring, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSA0216641 Issued in NM

Practice address

228 N Schwartz Ave
Farmington, NM 87401-5547

Phone

(505) 327-4584

NPI assigned

Apr 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cottonwood Clinical Services, Inc.

  • Community/Behavioral Health Agency
  • Farmington, NM
  • NPI 1790019420

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1629657747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 W ARRINGTON ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018513",
            "telephone_number": "505-564-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 N SCHWARTZ AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015547",
            "telephone_number": "505-327-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLBRING",
        "first_name": "ANNALISSA",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0216641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CSA0216641",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "annalissa@cottonwood.us.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "228 N Schwartz Ave",
            "city": "Farmington",
            "state": "NM",
            "country_code": "US",
            "postal_code": "874015547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mathew Theron Southwick, P.A.-C.
• Minnie Ann Sparks, P.T.
• Jacquelyn Speake, LPCC
• Daryl Leroy Specht, DDS
• Special K Fitness, Inc.
• Tami Spellbring
• James J Spence, MD
• Robert F. Sprung Jr., M.D.
• SSS Skincare and Wellness, LLC Dba Skinsationmd
• Rhenna St. Clair

• Addiction (Substance Use Disorder) Counselor in Farmington, NM
• Providers in Farmington, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.