COPPER CANYON WELLNESS, LLC (NPI# 1811433212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811433212 |
| Entity Type | Organization |
| Organization Name | COPPER CANYON WELLNESS, LLC |
| Practice Address |
1350 Central Ave Suite 204 Los Alamos NM 87544-3244 |
| Practice Telephone | 5056602654 |
| Mailing Telephone | 5056602654 |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |
| Authorized Official Name | DAWN J BARR (OWNER) |
| Authorized Official Telephone | 5056602654 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
NM C4131 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 81130210 | 05 |
| Street Address |
1350 CENTRAL AVE SUITE 204 |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544-3244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023076197 | Physical Therapy Plus Inc | Physical Therapist | 1350 Central Ave, Ste 105, Los Alamos, NM 87544 | 2006-05-01 |
| 1790316131 | Camille L Sackett-wescott | Occupational Therapist | 1350 Central Ave, Los Alamos, NM 87544-3244 | 2020-02-03 |
| 1629596903 | Christian Montoya | Physical Therapist | 1350 Central Ave, Los Alamos, NM 87544-3244 | 2017-09-06 |
| 1386032720 | Dana Brake | Physical Therapist | 1350 Central Ave, Los Alamos, NM 87544-3244 | 2015-01-08 |
| 1043459217 | Mari L Jorgensen | Physical Therapist | 1350 Central Ave, Suite 105, Los Alamos, NM 87544-3244 | 2009-02-11 |
| 1447430103 | Megan T Lausen | Physical Therapist | 1350 Central Ave, P.t. Plus, Los Alamos, NM 87544 | 2007-11-10 |
| 1952599060 | Amelyn D'egidio | Licensed Practical Nurse | 1350 Central Ave, Suite 105, Los Alamos, NM 87544-3244 | 2007-10-15 |
| 1548341399 | Annette Weyrauch | Physical Therapist | 1350 Central Ave, Suite 105, Los Alamos, NM 87544-3244 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| Find all providers in zip 87544 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790330207 | Alder and Oak Counseling LLC | Social Worker | 1350 Central Ave Ste 204, Los Alamos, NM 87544-6218 | 2019-08-02 |
| 1750753927 | Gls Clinical Social Work LLC | Social Worker | 1505 15th St Ste D, Los Alamos, NM 87544-3000 | 2015-10-27 |
| 1194147926 | Carmela Alcon | Social Worker | 4013 Urban St Apt A, Los Alamos, NM 87544-1794 | 2014-01-14 |
| 1093011975 | Laura Denise Lockwood | Social Worker | 2041 46th St, Los Alamos, NM 87544-1718 | 2011-02-10 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1841336542 | Jamie Silverman | Social Worker | 1907 Central Ave Ste 200, Los Alamos, NM 87544-4017 | 2007-01-29 |
| 1285784553 | Tom Steward | Social Worker | 62 Grand Canyon Dr, Los Alamos, NM 87544-3400 | 2007-01-11 |
| 1699012245 | Northern New Mexico Counseling Services, L.L.C. | Social Worker | 555 Oppenheimer Dr, Suite 200, Los Alamos, NM 87544-2384 | 2013-01-15 |
| 1407105802 | Miriam Thorp | Social Worker | 555 Oppenheimer Dr, Suite 200, Los Alamos, NM 87544-2384 | 2012-08-31 |
| 1578792586 | Pamela Nash Mathews | Social Worker | 127 Eastgate Dr, Suite 206, Los Alamos, NM 87544-3300 | 2009-07-11 |
| Find all providers in LOS ALAMOS | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
Please comment or provide details below to improve the information on COPPER CANYON WELLNESS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.