Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brian Evans Wilson, CPSW

Individual provider Peer Specialist · NPI 1417769001

Brian Evans Wilson, CPSW is a Peer Specialist in Gamerco, New Mexico. Works from 2 locations. Licensed in New Mexico.

Licensed in
NM
In the registry since
2025

Practice location Address checks out

309 S Chino Loop
Gamerco, NM 87317
Phone: (505) 488-2380
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2915 W Historic Highway 66 Rm 1203, Gallup, NM 87301-6812 — (505) 870-1483

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence 1476 (NM)

Record details

NPI number1417769001
Entity typeIndividual (Type 1)
GenderMale
Credentials CPSW
Sole proprietorNo
NPI enumeratedJanuary 22, 2025
Last updated in NPPESJanuary 22, 2025
Certification dateJanuary 16, 2025
Mailing addressPo Box 3809, Gallup, NM 87305-3809