COPPER CANYON WELLNESS LLC NPI 1811433212

NPI Information

  • NPI: 1811433212
  • Provider Name: COPPER CANYON WELLNESS, LLC
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 1350 CENTRAL AVE
    SUITE 204
    LOS ALAMOS, NM
    ZIP 87544
  • Phone: (505) 660-2654

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NPI Details

COPPER CANYON WELLNESS, LLC is a clinical social worker in Los Alamos, NM. The provider is 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. COPPER CANYON WELLNESS, LLC NPI is 1811433212. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1350 CENTRAL AVE
SUITE 204
LOS ALAMOS, NM
ZIP 87544-244
Phone: (505) 660-2654

The provider's authorized official is Dawn J Barr .
The authorized official title is Owner and has the following contact phone number (505) 660-2654.

The enumeration date for this NPI number is 1/10/2017 and was last updated on 1/10/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalNM C4131NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
181130210MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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