Provider Demographics
NPI:1174008395
Name:VIALPANDO, AMY (LMHC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:VIALPANDO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5916 ANAHEIM AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1894
Mailing Address - Country:US
Mailing Address - Phone:505-291-6314
Mailing Address - Fax:
Practice Address - Street 1:5916 ANAHEIM AVE NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1894
Practice Address - Country:US
Practice Address - Phone:505-291-6314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0199611101YM0800X
NMCCMH0214071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMCMH0199611OtherNM COUNSELING AND THERAPY BOARD