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General NPI Number Information
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NPI Number | 1902313448
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Entity Type | Individual
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Provider Name | DEANNA C. BRUER LMHC, NCC, LSAA
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Gender | Female
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 1201 3RD ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-1403
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Country | US
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Telephone | 505-460-1562
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Fax |
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Provider Business Mailing Address
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Address Line | 315 W HALEY ST STE 102
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City | SANTA BARBARA
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State | CA
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Zip | 93101-8052
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Country | US
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Telephone | 59-631-0868
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Fax | 805-963-5061
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CSA0220511
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CTB-2023-0624
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License Number State | NM
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