Healthcare Provider Details

I. General information

NPI: 1962521922
Provider Name (Legal Business Name): ELENA ABEYTA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELENA ARROYO

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 PASEO DEL PUEBLO SUT
TAOS NM
87571
US

IV. Provider business mailing address

PO BOX 70202
ALBUQUERQUE NM
87197-0202
US

V. Phone/Fax

Practice location:
  • Phone: 575-758-7263
  • Fax: 575-758-7176
Mailing address:
  • Phone: 818-397-4072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0174031
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: