Provider Demographics
NPI:1326110453
Name:TRUE, ELBA VELEZ (LPCC LADAC)
Entity Type:Individual
Prefix:MS
First Name:ELBA
Middle Name:VELEZ
Last Name:TRUE
Suffix:
Gender:F
Credentials:LPCC LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91A OJO RD
Mailing Address - Street 2:
Mailing Address - City:JEMEZ PUEBLO
Mailing Address - State:NM
Mailing Address - Zip Code:87024-9606
Mailing Address - Country:US
Mailing Address - Phone:505-429-1926
Mailing Address - Fax:
Practice Address - Street 1:110 SHEEP SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:JEMEZ PUEBLO
Practice Address - State:NM
Practice Address - Zip Code:87024
Practice Address - Country:US
Practice Address - Phone:505-834-7258
Practice Address - Fax:505-834-9507
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0069442101YA0400X
NM0071701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM29557054Medicaid