Provider Demographics
NPI:1295561645
Name:COMPOCCIO, VICTORIA ANN (STUDENT INTERN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANN
Last Name:COMPOCCIO
Suffix:
Gender:F
Credentials:STUDENT INTERN
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:ANN
Other - Last Name:COMPOCCIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 45022
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87174-5022
Mailing Address - Country:US
Mailing Address - Phone:505-226-1217
Mailing Address - Fax:
Practice Address - Street 1:333 RIO RANCHO BLVD NE STE 301
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1456
Practice Address - Country:US
Practice Address - Phone:505-226-0575
Practice Address - Fax:505-461-6271
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB20250533101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty