Brad K Holmgren, LISW – Clinical Social Worker

Key facts

NPI: 1699804286
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: I3761 (NM)
Practice address: 900 Central
Bayard, NM 88023
Phone: (505) 537-4000
Fax: (505) 537-3358
NPI assigned: Mar 2, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Cobre Consolidated Schools Local Education Agency (LEA) · Bayard, NM · NPI 1477683316

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
I3761	NM	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Cobre Consolidated Schools		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	I3761	NM	Yes

Addresses

Primary practice location

900 Central
Bayard, NM 88023

Mailing address

226 N. California Ave
Silver City, NM 88061
Phone (505) 388-0263

Other identifiers

Identifier	Type	State	Issuer
R8449	Medicaid	NM

Other providers in Bayard, NM

All providers in Bayard, NM · Clinical Social Worker in New Mexico

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.

Verify at the official NPI Registry.