South West Healing and Change LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0146921 Issued in NM

Legal business name

SOUTH WEST HEALING AND CHANGE LLC

Practice address

1424 Deborah Road SE
Rio Rancho, NM 87124

Phone

(505) 415-8085

NPI assigned

Mar 19, 2015

Organization subpart

No

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

Authorized official

Name

Maureen Brickley

Title

LPCC/Owner

Phone

(215) 803-5261

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1861886632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 SPAIN ROAD NE",
            "address_2": "SUITE 106",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093155",
            "telephone_number": "505-384-7352",
            "fax_number": "505-274-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 DEBORAH ROAD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "87124",
            "telephone_number": "505-415-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH WEST HEALING AND CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "BRICKLEY",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "LPCC/OWNER",
        "authorized_official_telephone_number": "215-803-5261"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0146921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.