Healthcare Provider Details

I. General information

NPI: 1255069126
Provider Name (Legal Business Name): VERONICA FORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MOUNTAIN RD NW
ALBUQUERQUE NM
87104-1359
US

IV. Provider business mailing address

9912 ACADEMY KNOLLS DR NE
ALBUQUERQUE NM
87111-1733
US

V. Phone/Fax

Practice location:
  • Phone: 505-557-4656
  • Fax:
Mailing address:
  • Phone: 505-559-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: