Provider Demographics
NPI:1235577735
Name:TRUJILLO, AMELIA (PHD, LMFT, PMH-C)
Entity type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:PHD, LMFT, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:
Mailing Address - City:JEMEZ SPRINGS
Mailing Address - State:NM
Mailing Address - Zip Code:87025-0192
Mailing Address - Country:US
Mailing Address - Phone:505-263-4184
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 192
Practice Address - Street 2:
Practice Address - City:JEMEZ SPRINGS
Practice Address - State:NM
Practice Address - Zip Code:87025-0192
Practice Address - Country:US
Practice Address - Phone:505-263-4184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NM0189251106H00000X
NM106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor