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General NPI Number Information
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NPI Number | 1063859015
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Entity Type | Organization
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Legal Business Name | VAILLANCOURT ASSOCIATES LLC DBA ALAMEDA MARRIAGE AND FAMILY THERAPY
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Dates
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Enumeration Date | 05/31/2013
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 304 W GRIGGS AVE STE C
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City | LAS CRUCES
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State | NM
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Zip | 88005-2603
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Country | US
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Telephone | 575-405-7146
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Fax | 575-405-5446
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Provider Business Mailing Address
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Address Line | 619 N ALAMEDA BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88005-2130
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Country | US
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Telephone | 575-405-7146
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Fax | 575-405-5446
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Authorized Official
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Title or Position | CEO
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Name | DR. KOURTNEY T. VAILLANCOURT
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Credential | LMFT, LADAC, CFLE
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Telephone | 575-405-7146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0109041
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License Number State | NM
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