Healthcare Provider Details

I. General information

NPI: 1093174138
Provider Name (Legal Business Name): LAURALYN ANN PRYOR LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURIE PRYOR LPCC

II. Dates (important events)

Enumeration Date: 02/17/2016
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 OLD PECOS TRL STE D
SANTA FE NM
87505-4768
US

IV. Provider business mailing address

2505 CAMINO ALFREDO
SANTA FE NM
87505-6426
US

V. Phone/Fax

Practice location:
  • Phone: 505-695-8223
  • Fax:
Mailing address:
  • Phone: 505-695-8223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0197971
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: