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General NPI Number Information
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NPI Number | 1063682458
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Entity Type | Organization
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Legal Business Name | RIO VISTA COUNSELING
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 8417 WASHINGTON PL NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-1720
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Country | US
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Telephone | 505-507-4408
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Fax | 505-867-6059
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Provider Business Mailing Address
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Address Line | 8417 WASHINGTON PL NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-1720
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Country | US
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Telephone | 505-507-4408
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | ELIZABETH SUSAN SPEAKER
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Credential | LPCC
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Telephone | 505-507-4408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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