Healthcare Provider Details

I. General information

NPI: 1275268419
Provider Name (Legal Business Name): CORA ANN BOYD LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7615 VIA COMETA SW
ALBUQUERQUE NM
87121-2336
US

IV. Provider business mailing address

7615 VIA COMETA SW
ALBUQUERQUE NM
87121-2336
US

V. Phone/Fax

Practice location:
  • Phone: 505-903-9603
  • Fax:
Mailing address:
  • Phone: 505-903-9603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2025-0609
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: