Healthcare Provider Details

I. General information

NPI: 1609362763
Provider Name (Legal Business Name): ALAYNA OROZCO MA LPCC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 07/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 COMANCHE RD NE
ALBUQUERQUE NM
87107-4546
US

IV. Provider business mailing address

951 ALEGRIA CT
LOS LUNAS NM
87031-8586
US

V. Phone/Fax

Practice location:
  • Phone: 505-417-7261
  • Fax:
Mailing address:
  • Phone: 505-417-7261
  • 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: ALAYNA OROZCO
Title or Position: SOLE MEMBER
Credential: MA, LPCC
Phone: 505-417-7261