Provider Demographics
NPI:1609246891
Name:LOYA PEDRAZA, SOPHIA (LMHC/LSAA)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:LOYA PEDRAZA
Suffix:
Gender:F
Credentials:LMHC/LSAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 FOOTHILLS RD
Mailing Address - Street 2:STE #8
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4632
Mailing Address - Country:US
Mailing Address - Phone:915-356-4629
Mailing Address - Fax:575-815-7016
Practice Address - Street 1:3850 FOOTHILLS RD
Practice Address - Street 2:STE #8
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4632
Practice Address - Country:US
Practice Address - Phone:915-356-4629
Practice Address - Fax:575-815-7016
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0174321101YA0400X
NM0174431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)