Provider Demographics
NPI:1851717730
Name:VALDEZ SIMPKINS, ANNESSA (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:ANNESSA
Middle Name:
Last Name:VALDEZ SIMPKINS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60025 CANTINA ACRES
Mailing Address - Street 2:
Mailing Address - City:GRANTS
Mailing Address - State:NM
Mailing Address - Zip Code:87020-9644
Mailing Address - Country:US
Mailing Address - Phone:505-658-0052
Mailing Address - Fax:
Practice Address - Street 1:310 W HIGH ST STE F
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-2566
Practice Address - Country:US
Practice Address - Phone:505-658-0052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0195271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional