Healthcare Provider Details

I. General information

NPI: 1538028758
Provider Name (Legal Business Name): BRII SEBASTIAN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 SPRUCE ST
SANTA FE NM
87501-1624
US

IV. Provider business mailing address

228 SPRUCE ST
SANTA FE NM
87501-1624
US

V. Phone/Fax

Practice location:
  • Phone: 505-577-9724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1205-16
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number1205-16
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCCMH0222421
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: