Healthcare Provider Details

I. General information

NPI: 1396052361
Provider Name (Legal Business Name): SAMARI RODRIGUEZ-RIOS PH.D., LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2010
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 GALISTEO ST STE H2
SANTA FE NM
87505-2106
US

IV. Provider business mailing address

5916 ANAHEIM AVE NE STE A
ALBUQUERQUE NM
87113-1894
US

V. Phone/Fax

Practice location:
  • Phone: 505-291-6314
  • Fax: 505-275-0296
Mailing address:
  • Phone: 505-291-6314
  • Fax: 505-275-0296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2022-0728
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: