Provider Demographics
NPI:1689941551
Name:ARREY, VICTOR MANUEL (MPA, LADAC)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:MANUEL
Last Name:ARREY
Suffix:
Gender:M
Credentials:MPA, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WALTER ST SE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-4658
Mailing Address - Country:US
Mailing Address - Phone:505-715-9328
Mailing Address - Fax:505-242-1158
Practice Address - Street 1:380 DOLORES DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-1954
Practice Address - Country:US
Practice Address - Phone:505-715-9328
Practice Address - Fax:505-242-1158
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3841101YA0400X
NM2364101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health