IndividualActive
Brian Wilson, CPSW
NPI 1417769001 · Peer Specialist · Gamerco, NM
Provider details
- NPI number
- 1417769001
- Entity type
- Individual
- Primary specialty
- Peer SpecialistOther Service Providers
- Credential
- CPSW
- Sex
- Male
- Sole proprietor
- No
- License
- 1476 (NM)
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
309 S. Chino Loop
Gamerco, NM 87317
Phone: (505) 488-2380
Street-level locationGet directions
Mailing address
Po Box 3809
Gallup, NM 87305-3809
Additional practice locations (1)
- 2915 W Historic Highway 66 Rm 1203Gallup, NM 87301-6812Phone: (505) 870-1483
Registry dates
- Enumerated
- 2025-01-22
- Last updated
- 2025-01-22
- Certified
- 2025-01-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.