Healthcare Provider Details

I. General information

NPI: 1396102505
Provider Name (Legal Business Name): ARIANNA TROTT LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 11/28/2024
Certification Date: 11/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80-B VETERANS BLVD
ACOMITA NM
87034
US

IV. Provider business mailing address

7506B OLD SANTA FE TRL
SANTA FE NM
87505-9342
US

V. Phone/Fax

Practice location:
  • Phone: 505-552-5312
  • Fax:
Mailing address:
  • Phone: 505-310-9924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0170121
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCCMH0191771
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: