Healthcare Provider Details

I. General information

NPI: 1861913535
Provider Name (Legal Business Name): DEBORAH DUPRIEST LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 BARBARA LOOP SE
RIO RANCHO NM
87124-1000
US

IV. Provider business mailing address

408 ALBOR CIR NE
RIO RANCHO NM
87124-0834
US

V. Phone/Fax

Practice location:
  • Phone: 505-702-8547
  • Fax: 704-254-3002
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0166471
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0213511
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: