Provider Demographics
NPI:1427473958
Name:ORTIZ, VANESSA ELENA (LPCC)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:ELENA
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 ZUNI RD SE
Mailing Address - Street 2:FIRST NATIONS COMMUNITY HEALTHSOURCE
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-2926
Mailing Address - Country:US
Mailing Address - Phone:505-265-2481
Mailing Address - Fax:505-262-7045
Practice Address - Street 1:5608 ZUNI RD SE
Practice Address - Street 2:FIRST NATIONS COMMUNITY HEALTH SOURCE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2926
Practice Address - Country:US
Practice Address - Phone:505-265-2481
Practice Address - Fax:505-262-7045
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0156991101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor