Healthcare Provider Details

I. General information

NPI: 1104263375
Provider Name (Legal Business Name): STERLING HALE BROWN PMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 COORS BLVD NW STE 308
ALBUQUERQUE NM
87120-1173
US

IV. Provider business mailing address

2929 COORS BLVD NW STE 308
ALBUQUERQUE NM
87120-1173
US

V. Phone/Fax

Practice location:
  • Phone: 505-373-1191
  • Fax:
Mailing address:
  • Phone: 505-373-1191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-09361
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: