Individual provider Active NPI

Brenda Leos, LMHC

  • Mental Health Counselor
  • Roswell, NM
National Provider Identifier
1770958852
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0176671 Issued in NM
Practice address
110 E Mescalero Rd
Roswell, NM 88201-6542
Phone
(575) 755-2272
Fax
(575) 622-3325
NPI assigned
Dec 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0176671 NM Primary

Addresses

Primary practice location

110 E Mescalero Rd
Roswell, NM 88201-6542

Mailing address

1515 W Fir St
Portales, NM 88130-5703
Phone (575) 356-6695

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0176671NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1770958852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W FIR ST",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881305703",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MESCALERO RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016542",
            "telephone_number": "575-755-2272",
            "fax_number": "575-622-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEOS",
        "first_name": "BRENDA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0176671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.