Provider Demographics
NPI:1134768716
Name:TRUJILLO, FREIDA ANN (MA, LPCC, BHC)
Entity type:Individual
Prefix:
First Name:FREIDA
Middle Name:ANN
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:MA, LPCC, BHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4169 MONTGOMERY BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6742
Mailing Address - Country:US
Mailing Address - Phone:505-315-8213
Mailing Address - Fax:
Practice Address - Street 1:4169 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6742
Practice Address - Country:US
Practice Address - Phone:505-315-8213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0166991101YM0800X
NMCCMH0217101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health