Healthcare Provider Details

I. General information

NPI: 1255291779
Provider Name (Legal Business Name): BRIANNA DENENNY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 11/19/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 VALENTINE WAY
SANTA FE NM
87507-7301
US

IV. Provider business mailing address

6601 VALENTINE WAY
SANTA FE NM
87507-7301
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-1951
  • Fax:
Mailing address:
  • Phone: 505-988-1951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2025-0832
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberCTB-2025-0810
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: