Kourtney T. Vaillancourt, PH.D, LMFT, LADAC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0109041 Issued in NM

Practice address

619 N Alameda Blvd
Las Cruces, NM 88005-2130

Phone

(575) 405-7146

Fax

(575) 405-5446

NPI assigned

Aug 20, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vaillancourt Associates LLC Dba Alameda Marriage and Family Therapy

  • Marriage & Family Therapist
  • Las Cruces, NM
  • NPI 1063859015
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1003009432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 N ALAMEDA BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052130",
            "telephone_number": "575-405-7146",
            "fax_number": "575-405-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 N ALAMEDA BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052130",
            "telephone_number": "575-405-7146",
            "fax_number": "575-405-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAILLANCOURT",
        "first_name": "KOURTNEY",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "PH.D, LMFT, LADAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0109031",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0102221",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "0109041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80302386",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Usrc Las Cruces LLC
• Usrc Lenox Avenue, LLC
• Amanda Vaccaro, OTR
• Jessica Vacha
• Vaillancourt Associates LLC Dba Alameda Marriage and Family Therapy
• Karen Vaillant, MD
• Paul A Vakselis, MD
• Viridiana Valadez, MCJ
• Angelina M. Valdespino, LCSW
• Corina Valdespino, LMSW

• Marriage & Family Therapist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Marriage & Family Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.