Active NPI
Brenda White, CSW
- Counselor
- Santa Rosa, NM
National Provider Identifier
1811568868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1047 Lake Dr
Santa Rosa, NM 88435-2561 - Phone
- (575) 472-5383
- NPI assigned
- Jul 9, 2021
- Last updated
- Jul 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary |
Addresses
Primary practice location
1047 Lake Dr
Santa Rosa, NM 88435-2561
Mailing address
1047 Lake Dr
Santa Rosa, NM 88435-2561
Phone (575) 472-5383
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matt 25 Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625788800000",
"number": "1811568868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1047 LAKE DR",
"city": "SANTA ROSA",
"state": "NM",
"postal_code": "884352561",
"telephone_number": "575-472-5383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1047 LAKE DR",
"city": "SANTA ROSA",
"state": "NM",
"postal_code": "884352561",
"telephone_number": "575-472-5383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "BRENDA",
"name_prefix": "Ms.",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-09",
"last_updated": "2021-07-09",
"certification_date": "2021-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.