Healthcare Provider Details

I. General information

NPI: 1205364742
Provider Name (Legal Business Name): BRIAN D PARKHILL MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2017
Last Update Date: 05/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SAINT MICHAELS DR
SANTA FE NM
87505-7630
US

IV. Provider business mailing address

PO BOX 4144
SANTA FE NM
87502-4144
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-1540
  • Fax: 505-983-1508
Mailing address:
  • Phone: 505-983-1540
  • Fax: 505-983-1508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1860
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: