Healthcare Provider Details

I. General information

NPI: 1790329704
Provider Name (Legal Business Name): BRIAN SCHURTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2019
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 MESILLA ST NE
ALBUQUERQUE NM
87110-3686
US

IV. Provider business mailing address

9301 INDIAN SCHOOL RD NE STE 205A
ALBUQUERQUE NM
87112-2861
US

V. Phone/Fax

Practice location:
  • Phone: 505-933-3193
  • Fax:
Mailing address:
  • Phone: 505-933-3193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB20250686
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: