Provider Demographics
NPI:1487265849
Name:JAURE, BRANDI (LMSW)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:JAURE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 W HESTER ST
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-4316
Mailing Address - Country:US
Mailing Address - Phone:575-313-9802
Mailing Address - Fax:
Practice Address - Street 1:4042 HIGHWAY 90 S
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-9172
Practice Address - Country:US
Practice Address - Phone:575-956-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-106071041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool