Healthcare Provider Details

I. General information

NPI: 1467582783
Provider Name (Legal Business Name): DEBRA VEGA-COWAN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 DESI LOOP
BELEN NM
87002-8026
US

IV. Provider business mailing address

4169 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-6742
US

V. Phone/Fax

Practice location:
  • Phone: 505-860-3205
  • Fax:
Mailing address:
  • Phone: 505-261-9770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0115591
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: