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Contact Information

VISTA CLARA COUNSELING LLC
2005 RT 66 W
SUITE F
MORIARTY, NM87035
 Phone: 505-433-8822
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for VISTA CLARA COUNSELING LLC · (Female)

NPI # 1114690443
Status Active
Credentials
Entity Individual
Enumeration date 08/02/2021
Last updated 08/02/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • NM Medicaid 77179579
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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