Healthcare Provider Details

I. General information

NPI: 1750238705
Provider Name (Legal Business Name): BC BRAINYOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CENTRAL AVE SW STE A
ALBUQUERQUE NM
87102-3298
US

IV. Provider business mailing address

1527 SUNSET FARM RD SW
ALBUQUERQUE NM
87105-2771
US

V. Phone/Fax

Practice location:
  • Phone: 505-585-1492
  • Fax:
Mailing address:
  • Phone: 505-369-6944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: AVA N PLAKIO
Title or Position: OWNER/CLINICIAN
Credential: MA, LPCC
Phone: 505-369-6944