| Brain And Behavioral Associates, Pc | |
|
1300 Central Ave Sw Albuquerque NM 87102-2805 | |
| (505) 243-0335 | |
| (505) 216-2623 |
| Full Name | Brain And Behavioral Associates, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1300 Central Ave Sw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Rex Eugene Jung (OWNER) |
| Authorized Official Contact | 5059180066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain And Behavioral Associates, Pc 1300 Central Ave Sw Albuquerque NM 87102-2805 Ph: (505) 243-0335 | Brain And Behavioral Associates, Pc 1300 Central Ave Sw Albuquerque NM 87102-2805 Ph: (505) 243-0335 |
| NPI Number | 1467747477 |
|---|---|
| Provider Enumeration Date | 06/17/2011 |
| Last Update Date | 10/12/2020 |
| Certification Date | 10/12/2020 |
| Medicare PECOS PAC ID | 2365616018 |
|---|---|
| Medicare Enrollment ID | O20111116000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467747477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 0880 (New Mexico) | Primary |
| Provider Name | Rex E Jung |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801802558 PECOS PAC ID: 9335136944 Enrollment ID: I20040427000571 |
| Provider Name | Lynette M Abrams Silva |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326446881 PECOS PAC ID: 5799004271 Enrollment ID: I20170921000218 |
| Provider Name | Sephira Gillion Ryman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477140630 PECOS PAC ID: 2860891892 Enrollment ID: I20210525001448 |
| Provider Name | Travis Martin Shivley-scott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609445444 PECOS PAC ID: 5698136836 Enrollment ID: I20230803002188 |
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