Matthew Christopher Bryan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SWB-2022-0411 Issued in NM

Practice address

185 Osprey CT
Santa Teresa, NM 88008-9502

Phone

(915) 873-5672

NPI assigned

Aug 10, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Passionate Minds Behavioral Health LLC

  • Clinical Social Worker
  • Santa Teresa, NM
  • NPI 1205675154

  Clinical

  NPD Authorized official
• Rydan Solutions Inc

  • Substance Abuse Rehabilitation Facility
  • Las Cruces, NM
  • NPI 1245904879
  NPD (past)
• Rydan Solutions Inc

  • Substance Abuse Rehabilitation Facility
  • Las Cruces, NM
  • NPI 1386139780
  NPD (past)

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1679184147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 OSPREY CT",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089502",
            "telephone_number": "915-873-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 OSPREY CT",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089502",
            "telephone_number": "915-873-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTOPHER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-10",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2022-0411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Estrellita Blanco, RNC, WHCNP
• Tomas Bravo Jr
• Yesenia Maria Bravo
• Christian Brito
• Tania Bryan-Romero, LMSW
• Alexandria Bryant
• Buen Salud Inc
• Yadira Bueno
• Maria Lourdes Burciaga, MA, LMHC
• Anabel Bustos

• All providers in Santa Teresa, NM
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.