Brain Injury Services of New Mexico, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

BRAIN INJURY SERVICES OF NEW MEXICO, LLC

Practice address

1115 N Luna Cir
Santa Fe, NM 87501-1656

Phone

(505) 989-1640

Fax

(505) 989-1640

NPI assigned

Jun 3, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa Ann Wolf, LPCC

Title

Director

Phone

(505) 989-1640

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307059200000",
    "number": "1891089280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 N LUNA CIR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011656",
            "telephone_number": "505-989-1640",
            "fax_number": "505-989-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N LUNA CIR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011656",
            "telephone_number": "505-989-1640",
            "fax_number": "505-989-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN INJURY SERVICES OF NEW MEXICO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-989-1640",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Bradish
• Mark Stephen Bradley, MD
• Mary E Bradshaw, LPCC
• Mary Bradtke, LMHC
• Roisin Michelle Brady
• Brain-Body-Spirit- LLC
• Rebekah Jo Brandon, LMHC
• Lydia Grace Brandt
• Nancy Brandt, MA LISW
• Dean H Branson, DO

• Professional Counselor in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.