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NPI Code Detail

MEDICARE: DEANNA C. BRUER LMHC, NCC, LSAA

MEDICARE: DEANNA C. BRUER LMHC, NCC, LSAA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCSA0220511NM
2101YM0800XMental Health CounselorCTB-2023-0624NM

General Provider Information

NPI Number : 1902313448
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA C. BRUER LMHC, NCC, LSAA
Provider Business Mailing Address
First Line : 315 W HALEY ST STE 102
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93101-8052
Country : US
Telephone Number : 59-631-0868
Fax Number : 805-963-5061
Provider Business Practice Location Address
First Line : 1201 3RD ST NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87102-1403
Country : US
Telephone Number : 505-460-1562
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2018
Last Update Date : 11/02/2023

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