Healthcare Provider Details

I. General information

NPI: 1902313448
Provider Name (Legal Business Name): DEANNA C. BRUER LMHC, NCC, LSAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2018
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 3RD ST NW
ALBUQUERQUE NM
87102-1403
US

IV. Provider business mailing address

315 W HALEY ST STE 102
SANTA BARBARA CA
93101-8052
US

V. Phone/Fax

Practice location:
  • Phone: 505-460-1562
  • Fax:
Mailing address:
  • Phone: 59-631-0868
  • Fax: 805-963-5061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCSA0220511
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2023-0624
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: