Healthcare Provider Details

I. General information

NPI: 1942856075
Provider Name (Legal Business Name): VESTA PADILLA LPCC, LADAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 VERANO CT NW
ALBUQUERQUE NM
87120-6031
US

IV. Provider business mailing address

4300 HENDRIX RD NE
ALBUQUERQUE NM
87110-1091
US

V. Phone/Fax

Practice location:
  • Phone: 505-553-2888
  • Fax:
Mailing address:
  • Phone: 505-553-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2024-0696
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAD0213671
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: