Stuppy, John Bryan

Stuppy, John Bryan is an individual health care provider with primary practice located at 2891 Clark Ct , Santa Fe NM 87507-5179. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Stuppy, John Bryan can be contacted via phone (505) 930-4550.

Contact Information

Primary practice address
2891 Clark Ct Santa Fe NM 87507-5179
Phone: (505) 930-4550
Fax: (505) 474-4550
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X I-6160 New Mexico
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 3419 New Mexico

Profile Details

NPI number 1811982135
LBN Legal business name Stuppy, John Bryan
Credentials LISW, LADAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Jan 17th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811982135 NPPES
New Mexico MEDICAID 60759364
New Mexico MEDICAID 53052552

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