Healthcare Provider Details

I. General information

NPI: 1760336614
Provider Name (Legal Business Name): VICTORIA LORRAINE VALLES-MORA MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICKI L. VALLES-MORA MA, LPCC

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7425 4TH ST NW
LOS RANCHOS NM
87107-6627
US

IV. Provider business mailing address

6305 LITTLE JOE PL NW
ALBUQUERQUE NM
87120-3773
US

V. Phone/Fax

Practice location:
  • Phone: 505-259-7353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCCMH973
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: